MEDICARE: AUSTIN SPORTS MEDICINE LLP

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
1	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1278600001	OTHER	TX	MEDICARE DME SUPPLIER #

Other Identifiers

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

General Provider Information

NPI Number	:	1770553653
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUSTIN SPORTS MEDICINE LLP

Provider Business Mailing Address
First Line	:	900 W 38TH ST
Second Line	:	SUITE 300
City	:	AUSTIN
State	:	TX
Zip	:	78705-1130
Country	:	US
Telephone Number	:	512-450-1300
Fax Number	:	512-450-1339

Provider Business Practice Location Address
First Line	:	900 W 38TH ST
Second Line	:	SUITE 300
City	:	AUSTIN
State	:	TX
Zip	:	78705-1130
Country	:	US
Telephone Number	:	512-450-1300
Fax Number	:	512-450-1339

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JOHN M GUZZINO
Credential	:
Telephone Number	:	512-450-1300

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	02/07/2013

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Directions to “AUSTIN SPORTS MEDICINE LLP ” Practice Location

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