Provider Demographics
NPI:1649901711
Name:HUTCHINSON, STEVEN DAVID
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:DAVID
Last Name:HUTCHINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:STEVEN
Other - Middle Name:DAVID
Other - Last Name:HUTCHINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:7609 LUNAR DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-6564
Mailing Address - Country:US
Mailing Address - Phone:512-563-2974
Mailing Address - Fax:
Practice Address - Street 1:7609 LUNAR DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-6564
Practice Address - Country:US
Practice Address - Phone:512-563-2974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXGMR020085582085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology