Provider Demographics
NPI:1982605374
Name:ROEHM, ERIC F (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:F
Last Name:ROEHM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:PO BOX 4189
Mailing Address - Street 2:AUSTIN HEART
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78765-4189
Mailing Address - Country:US
Mailing Address - Phone:512-206-4300
Mailing Address - Fax:512-206-4350
Practice Address - Street 1:7200 WYOMING SPGS
Practice Address - Street 2:STE 1400, AUSTIN HEART, ROUND ROCK #1
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4303
Practice Address - Country:US
Practice Address - Phone:512-244-2263
Practice Address - Fax:512-244-0846
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXF4441207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
048695OtherGREAT WEST
78681-C002OtherCHAMPUS / TRICARE
TX50473OtherFIRST HEALTH
TX832880OtherBC/BS
TX12827253Medicaid
324409OtherUSA MANAGED CARE
4313543OtherAETNA / TRS
4313543OtherAETNA / TRS
TX12827253Medicaid