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8522 N Lamar Blvd Austin TX 78753-5543 | |
(512) 832-8448 | |
(512) 832-8454 |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 8522 N Lamar Blvd, Austin, Texas |
Authorized Official Name and Position | Michael Shayne Istre (DIRECT OWNER) |
Authorized Official Contact | 5124262619 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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8522 N Lamar Blvd Austin TX 78753-5543 Ph: (512) 832-8448 | 8522 N Lamar Blvd Austin TX 78753-5543 Ph: (512) 832-8448 |
NPI Number | 1447342159 |
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Provider Enumeration Date | 09/29/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447342159 | NPI | - | NPPES |
G60109-2 | Other | TX | TEXAS CHIP PROVIDER NUMBE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | 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 | |