Provider Demographics
NPI:1649202979
Name:BAPTISTE, REGINALD CARL (MD)
Entity Type:Individual
Prefix:DR
First Name:REGINALD
Middle Name:CARL
Last Name:BAPTISTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7000 N MO PAC EXPY STE 320
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3258
Mailing Address - Country:US
Mailing Address - Phone:512-583-0146
Mailing Address - Fax:512-583-0147
Practice Address - Street 1:12221 RENFERT WAY
Practice Address - Street 2:STE 345
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5444
Practice Address - Country:US
Practice Address - Phone:512-583-0146
Practice Address - Fax:512-583-0147
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH9770208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF03935Medicare UPIN
TX8C6238Medicare PIN