Healthcare Provider Details

I. General information

NPI: 1235399478
Provider Name (Legal Business Name): AUSTIN OB-GYN ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 11/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 MEDICAL ARTS ST BLDG 3
AUSTIN TX
78705-3376
US

IV. Provider business mailing address

2911 MEDICAL ARTS ST BLDG 3
AUSTIN TX
78705-3376
US

V. Phone/Fax

Practice location:
  • Phone: 512-391-0175
  • Fax: 512-476-4078
Mailing address:
  • Phone: 512-391-0175
  • Fax: 512-476-4078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberK7752
License Number StateTX

VIII. Authorized Official

Name: MRS. MELISSA GUZMAN WINN
Title or Position: OWNER / PROVIDER
Credential: M.D.
Phone: 512-391-0175