Provider Demographics
NPI:1689778946
Name:SCUMPIA, SIMONA MARIANA (MD)
Entity Type:Individual
Prefix:DR
First Name:SIMONA
Middle Name:MARIANA
Last Name:SCUMPIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SIMONE
Other - Middle Name:
Other - Last Name:SCUMPIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2200 PARK BEND DR
Mailing Address - Street 2:BLDG 3-300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5387
Mailing Address - Country:US
Mailing Address - Phone:512-873-7377
Mailing Address - Fax:512-873-7576
Practice Address - Street 1:2200 PARK BEND DR
Practice Address - Street 2:BLDG 3-300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5387
Practice Address - Country:US
Practice Address - Phone:512-873-7377
Practice Address - Fax:512-873-7576
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3521207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8X7500OtherBCBS
TX8834N0Medicare PIN
TXD87483Medicare UPIN