Provider Demographics
NPI:1629269816
Name:MALTZ, ASHLEY (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:MALTZ
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 WEST AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-2204
Mailing Address - Country:US
Mailing Address - Phone:512-814-0148
Mailing Address - Fax:505-272-8060
Practice Address - Street 1:904 WEST AVE STE 109
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-2204
Practice Address - Country:US
Practice Address - Phone:713-502-7607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2013-0240207R00000X
TXP5676207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine