Healthcare Provider Details

I. General information

NPI: 1003549767
Provider Name (Legal Business Name): ARISE MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2022
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 BEE CAVES RD
AUSTIN TX
78746-5542
US

IV. Provider business mailing address

3003 BEE CAVES RD
AUSTIN TX
78746-5542
US

V. Phone/Fax

Practice location:
  • Phone: 512-314-3800
  • Fax:
Mailing address:
  • Phone: 512-314-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL AGUILAR
Title or Position: DIRECTOR REVENUE CYCLE
Credential:
Phone: 512-299-4164