Provider Demographics
NPI:1295053643
Name:AUSTIN, GESHIA (MD)
Entity type:Individual
Prefix:DR
First Name:GESHIA
Middle Name:
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:GESHIA
Other - Middle Name:
Other - Last Name:BARRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 26726
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78755-0726
Mailing Address - Country:US
Mailing Address - Phone:512-407-8686
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:1807 W SLAUGHTER LN STE 490
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-6208
Practice Address - Country:US
Practice Address - Phone:512-282-8967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-10
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0036632208000000X
TXP5587208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX321491801Medicaid
TX321491802Medicaid
TX321491802Medicaid
TX321491801Medicaid