| |
5339 N Ih 35, Austin, TX 78723-2428 | |
(512) 892-7200 | |
(512) 892-7205 |
Full Name | |
---|---|
Type | Facility |
Speciality | Pediatrics |
Location | 5339 N Ih 35, Austin, Texas |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588898589 | NPI | - | NPPES |
153715101 | Medicaid | TX | |
082009401 | Medicaid | TX | |
153715103 | Medicaid | TX | |
153715105 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
208000000X | Pediatrics | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
5339 N Ih 35, 100, Austin, TX 78723-2428 Ph: (512) 892-7200 | 5339 N Ih 35, Austin, TX 78723-2428 Ph: (512) 892-7200 |