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1802 W Anderson Ln Austin TX 78757-1338 | |
(512) 459-4347 | |
(512) 459-4348 |
Full Name | |
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Speciality | Dentist |
Location | 1802 W Anderson Ln, Austin, Texas |
Authorized Official Name and Position | Gerald Bernard Pevow (OWNER) |
Authorized Official Contact | 5124594347 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1802 W Anderson Ln Austin TX 78757-1338 Ph: (512) 459-4347 | 1802 W Anderson Ln Austin TX 78757-1338 Ph: (512) 459-4347 |
NPI Number | 1457772816 |
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Provider Enumeration Date | 01/02/2014 |
Last Update Date | 01/02/2014 |
Identifier | Type | State | Issuer |
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1457772816 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 28268 (Texas) | Primary |
Jared Poplin D.m.d., Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6850 Austin Center Blvd Ste 220, Austin, TX 78731 Phone: 785-691-6171 | |
Ac Dentistry Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 13616 N Highway 183, Austin, TX 78750 Phone: 512-682-5437 | |