Basic Information
| Provider Information | |||||||||
| NPI: | 1699058719 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BEDNAR | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | ANDREW | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5625 EIGER RD STE 160 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787358980 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122981645 | ||||||||
| FaxNumber: | 5122981795 | ||||||||
| Practice Location | |||||||||
| Address1: | 4210 BENNER | ||||||||
| Address2: | |||||||||
| City: | KYLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786402230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122981795 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2011 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Q5973 | TX | N | Allopathic & Osteopathic Physicians | Anesthesiology | 208VP0014X | Q5973 | TX | Y | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine |
No ID Information.