Healthcare Provider Details

I. General information

NPI: 1770838146
Provider Name (Legal Business Name): H2 HEALTH CARE LTD, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2012
Last Update Date: 07/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 W 38TH ST
AUSTIN TX
78705-1121
US

IV. Provider business mailing address

711 W 38TH ST
AUSTIN TX
78705-1121
US

V. Phone/Fax

Practice location:
  • Phone: 512-453-1600
  • Fax: 512-453-1503
Mailing address:
  • Phone: 512-453-1600
  • Fax: 512-453-1503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number22581
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number20329
License Number StateTX

VIII. Authorized Official

Name: ALICIA POWELL
Title or Position: OFFICE MANAGER
Credential:
Phone: 512-453-1600