Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | H1154 | TX |
Y | 207RI0011X | Interventional Cardiology | H1154 | TX |
NPI | 1093798944 |
---|---|
Provider Name | Robert M Mingea III |
First Address | Austin, TX 78701-1926 |
Second Address | Lockhart, TX 78644-2713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2005 |
Last Update Date | 22/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
128744306 | (05) | TX |
128744307 | (05) | TX |
128744308 | (05) | TX |
128744309 | (05) | TX |
8DF128 | BCBS (01) | TX |
8ET190 | BCBS (01) | TX |
A99118 | (02) |