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5920 W William Cannon Dr Ste 210 Austin TX 78749-1902 | |
(512) 215-4350 | |
(512) 647-6367 |
Full Name | |
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Speciality | Durable Medical Equipment & Medical Supplies |
Location | 5920 W William Cannon Dr Ste 210, Austin, Texas |
Authorized Official Name and Position | Brandon Hedgecock (PRESIDENT) |
Authorized Official Contact | 5126330055 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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4009 Banister Ln Ste 370 Austin TX 78704-7040 Ph: (512) 215-4350 | 5920 W William Cannon Dr Ste 210 Austin TX 78749-1902 Ph: (512) 215-4350 |
NPI Number | 1164890323 |
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Provider Enumeration Date | 09/04/2015 |
Last Update Date | 07/19/2024 |
Medicare PECOS PAC ID | 4183913932 |
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Medicare Enrollment ID | O20160517002209 |
Identifier | Type | State | Issuer |
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1164890323 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 26159 (Texas) | Secondary |
332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | 26159 (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 | |