| Everly Provider Group Ks, P.a. | |
|
823 Congress Ave Ste 1200 Austin TX 78701-2402 | |
| (855) 422-3855 | |
| Not Available |
| Full Name | Everly Provider Group Ks, P.a. |
|---|---|
| Speciality | General Practice |
| Location | 823 Congress Ave Ste 1200, Austin, Texas |
| Authorized Official Name and Position | Brantley Tillman Jolly (OWNER/PRESIDENT) |
| Authorized Official Contact | 8554223855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Everly Provider Group Ks, P.a. 823 Congress Ave Ste 1200 Austin TX 78701-2402 Ph: () - | Everly Provider Group Ks, P.a. 823 Congress Ave Ste 1200 Austin TX 78701-2402 Ph: (855) 422-3855 |
| NPI Number | 1154185601 |
|---|---|
| Provider Enumeration Date | 02/06/2024 |
| Last Update Date | 06/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154185601 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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