person
Anthony Russo
General Practice Physician in Pflugerville, Texas
NPI 1700860400

Anthony Russo is a General Practice Physician based in Pflugerville, TX. Anthony Russo practices in Pflugerville, TX. The NPI Number for Anthony Russo is 1700860400 and holds a License No. G0039 (Texas).

The current practice location address for Anthony Russo is 2401 W Pecan St, Pflugerville, TX and can be reached out via phone at 512-251-5586.

Location: 2401 W Pecan St, Pflugerville, TX, 78660-3200
person
Provider Profile Details
NPI Number
1700860400
Provider Name
Anthony Russo
Credential
Provider Entity Type
Individual
Gender
Male
Address
2401 W Pecan St, Pflugerville, TX, 78660-3200
Phone Number
512-251-5586
Fax Number
Provider Enumeration Date
12/06/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00B91R 01 TX BLUE CROSS BLUE SHIELD TX
115675 01 TX AETNA
institution
Provider Business Practice Location Address Details
Address
2401 W Pecan St
City
State
Zip
78660-3200
Phone Number
512-251-5586
Fax Number
person
Provider Business Mailing Address Details
Address
2401 W Pecan St
City
State
Zip
78660-3200
Phone Number
512-251-5586
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
G0039 (Texas)
Definition
Definition to come...
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