MEDICARE: TRI-COUNTY CLINICAL

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	207R00000X	Internal Medicine Physician
3	207V00000X	Obstetrics & Gynecology Physician
4	208600000X	Surgery Physician
5	207RC0000X	Cardiovascular Disease Physician

Other Identifiers

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

Language	Start Address	Practice Location

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