| Auxanomen A Texas Non Profit Corp | |
|
2105 Parker Ln. Astin TX 78741 | |
| (512) 797-5169 | |
| (512) 383-9225 |
| Full Name | Auxanomen A Texas Non Profit Corp |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 2105 Parker Ln., Astin, Texas |
| Authorized Official Name and Position | Susan Kathleen Dubois (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5127975169 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Auxanomen A Texas Non Profit Corp 2105 Parker Ln. Austin TX 78741 Ph: (512) 797-5169 | Auxanomen A Texas Non Profit Corp 2105 Parker Ln. Astin TX 78741 Ph: (512) 797-5169 |
| NPI Number | 1861764219 |
|---|---|
| Provider Enumeration Date | 02/01/2012 |
| Last Update Date | 02/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861764219 | NPI | - | NPPES |
| 147296102 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | H61788 (Texas) | Primary |