Basic Information
Provider Information
NPI: 1548556913
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SOMOGYI
FirstName: JASON
MiddleName: ROBERT
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4700 SETON CENTER PKWY
Address2: STE 200
City: AUSTIN
State: TX
PostalCode: 787594107
CountryCode: US
TelephoneNumber: 5124391000
FaxNumber: 5124391081
Practice Location
Address1: 4700 SETON CENTER PKWY STE 200
Address2:  
City: AUSTIN
State: TX
PostalCode: 78759
CountryCode: US
TelephoneNumber: 5124391000
FaxNumber: 5124391081
Other Information
ProviderEnumerationDate: 06/23/2011
LastUpdateDate: 11/03/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/03/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XS0106XR6107TXY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery

No ID Information.


Home