is a Family in Austin, Texas. practices all healthcare services and medical treatments related to Family. The NPI Number for is 1417068370. The last update date is .
's current location address is 1201 W 49th St, Austin, Texas. You can contact this provider via phone number 5123740203. The mailing address for is 1201 W 49th St, Austin, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1201 W 49th St, Austin, Texas |
| Phone Number | 5123740203 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1417068370 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1201 W 49th St |
|---|---|
| City | Austin |
| State | Texas (TX) |
| Post Code | 787563102 |
| Phone Number | 5123740203 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | 565264 |
|
Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8N9688 | TX | BCBS TX INDIVID NO | |
| 173322201 | TX | -- | |
| 9381771 | TX | PCHS INDIV NO |
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