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6618 Sitio Del Rio Blvd Suite B-101 Austin TX 78730-1143 | |
(512) 524-2336 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 6618 Sitio Del Rio Blvd, Austin, Texas |
Authorized Official Name and Position | Martin C Molina (OWNER) |
Authorized Official Contact | 5125242336 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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6618 Sitio Del Rio Blvd Suite B-101 Austin TX 78730-1143 Ph: (512) 524-2336 | 6618 Sitio Del Rio Blvd Suite B-101 Austin TX 78730-1143 Ph: (512) 524-2336 |
NPI Number | 1043480171 |
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Provider Enumeration Date | 03/04/2008 |
Last Update Date | 09/23/2008 |
Medicare PECOS PAC ID | 6709952401 |
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Medicare Enrollment ID | O20080903000576 |
Identifier | Type | State | Issuer |
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1043480171 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | M0185 (Texas) | Primary |
Provider Name | Martin C Molina |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1700830338 PECOS PAC ID: 8628043015 Enrollment ID: I20050503000525 |
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 | |
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