Provider Demographics
NPI:1700375862
Name:FRAUTSCHI, RUSSELL SHANE (MD)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:SHANE
Last Name:FRAUTSCHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7004 BEE CAVES RD STE 2-100
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5086
Mailing Address - Country:US
Mailing Address - Phone:512-642-5050
Mailing Address - Fax:512-642-8186
Practice Address - Street 1:7004 BEE CAVES RD STE 2-100
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5086
Practice Address - Country:US
Practice Address - Phone:512-642-5050
Practice Address - Fax:512-642-8186
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-04
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV50732086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty