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NPI Code Detail

MEDICARE: TRI-COUNTY CLINICAL

MEDICARE: TRI-COUNTY CLINICAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2207R00000XInternal Medicine Physician
3207V00000XObstetrics & Gynecology Physician
4208600000XSurgery Physician
5207RC0000XCardiovascular Disease Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588971477
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRI-COUNTY CLINICAL
Provider Business Mailing Address
First Line : 1345 PHILOMENA ST
Second Line : SUITE 410.3
City : AUSTIN
State : TX
Zip : 78723
Country : US
Telephone Number : 512-324-8960
Fax Number :
Provider Business Practice Location Address
First Line : 3501 MILLS AVE
Second Line :
City : AUSTIN
State : TX
Zip : 78731
Country : US
Telephone Number : 512-324-2000
Fax Number :
Authorized Official
Title or Position : VP/COO
Name : CLAYTON CARNSER
Credential :
Telephone Number : 512-324-5846
Provider Enumeration Date : 09/13/2010
Last Update Date : 08/23/2023

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Directions to “TRI-COUNTY CLINICAL ” Practice Location

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