Provider Demographics
NPI:1710964382
Name:PAMPE, EUGENE DAVID (MD)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:DAVID
Last Name:PAMPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6012 WEST WILLIAM CANNON DRIVE STE D101
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-1979
Mailing Address - Country:US
Mailing Address - Phone:512-892-6441
Mailing Address - Fax:512-892-4154
Practice Address - Street 1:6012 WEST WILLIAM CANNON DRIVE STE D101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-1979
Practice Address - Country:US
Practice Address - Phone:512-892-6441
Practice Address - Fax:512-892-4154
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9917207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB25358Medicare UPIN
TX82910BMedicare PIN