Healthcare Provider Details
I. General information
NPI: 1013262369
Provider Name (Legal Business Name): PERIOPERATIVE PRECISION PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/23/2012
Last Update Date: 07/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6206 LONDON DR
AUSTIN TX
78745-3459
US
IV. Provider business mailing address
6206 LONDON DR
AUSTIN TX
78745-3459
US
V. Phone/Fax
- Phone: 512-751-3405
- Fax:
- Phone: 512-751-3405
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WR0006X |
| Taxonomy | Registered Nurse First Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CRAIG
ANDREW
VIRR
Title or Position: OWNER
Credential: RNFA
Phone: 512-751-3405