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505 W Louis Henna Blvd Ste 100 Austin TX 78728-1702 | |
| (512) 252-1505 | |
| (512) 252-1506 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 505 W Louis Henna Blvd Ste 100, Austin, Texas |
| Authorized Official Name and Position | Shane Edward Keller (PRESIDENT) |
| Authorized Official Contact | 5122521505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 4374 Houston TX 77210-4374 Ph: (512) 252-1505 | 505 W Louis Henna Blvd Ste 100 Austin TX 78728-1702 Ph: (512) 252-1505 |
| NPI Number | 1407870959 |
|---|---|
| Provider Enumeration Date | 07/27/2006 |
| Last Update Date | 12/10/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407870959 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | L8393 (Texas) | Primary |
Harold D Lewis Do Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 West William Cannon Drive, Suite 123, Austin, TX 78745 Phone: 512-444-2661 Fax: 512-444-2720 | |
Julie Graves Moy Md Mph Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8127 Mesa Dr, B206-54, Austin, TX 78759 Phone: 512-689-8001 | |
Edie E. Shulman M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11673 Jollyville Rd., Suite B-101, Austin, TX 78759 Phone: 512-339-1535 Fax: 512-339-1526 | |
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