| |
4101 Marathon Boulevard, Austin, TX 78756-4026 | |
(512) 323-9222 | |
(512) 323-9232 |
Full Name | |
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Type | Facility |
Speciality | Internal Medicine |
Location | 4101 Marathon Boulevard, Austin, Texas |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538314562 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111NI0900X | Chiropractor - Internist | DC30474 (Texas) | Secondary |
207R00000X | Internal Medicine | (Texas) | Primary |
Mailing Address | Practice Location Address |
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Po Box 303460, Austin, TX 78703-0058 Ph: (512) 323-9222 | 4101 Marathon Boulevard, Austin, TX 78756-4026 Ph: (512) 323-9222 |