Healthcare Provider Details

I. General information

NPI: 1659400059
Provider Name (Legal Business Name): WHOLE WOMAN'S HEALTH OF AUSTIN, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 N I H 35 SUITE 200
AUSTIN TX
78753-5751
US

IV. Provider business mailing address

8401 N I H 35 SUITE 1A
AUSTIN TX
78753-5751
US

V. Phone/Fax

Practice location:
  • Phone: 512-250-1005
  • Fax: 512-250-1066
Mailing address:
  • Phone: 512-835-6691
  • Fax: 512-250-1005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. AMY HAGSTROM MILLER
Title or Position: CEO
Credential:
Phone: 512-250-1005