| Dr. Av, Pllc | |
|
210 Lee Barton Dr Unit # 206 Austin TX 78704-1045 | |
| (210) 787-6621 | |
| (512) 904-5603 |
| Full Name | Dr. Av, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 210 Lee Barton Dr, Austin, Texas |
| Authorized Official Name and Position | Aleksandra Vidacic (HEALTHCARE PROFESSIONAL) |
| Authorized Official Contact | 2107876621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Av, Pllc Po Box 684905 Austin TX 78768-4905 Ph: (210) 787-6621 | Dr. Av, Pllc 210 Lee Barton Dr Unit # 206 Austin TX 78704-1045 Ph: (210) 787-6621 |
| NPI Number | 1902236003 |
|---|---|
| Provider Enumeration Date | 11/26/2013 |
| Last Update Date | 11/30/2013 |
| Medicare PECOS PAC ID | 4981837879 |
|---|---|
| Medicare Enrollment ID | O20140430000173 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902236003 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | N4181 (Texas) | Primary |
| Provider Name | Aleksandra Vidacic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629272224 PECOS PAC ID: 6901951474 Enrollment ID: I20090904000303 |
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