Healthcare Provider Details

I. General information

NPI: 1639591167
Provider Name (Legal Business Name): AUSTIN PRIMARY CARE PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2014
Last Update Date: 01/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 PARK BEND DR BUILDING 2 SUITE 300
AUSTIN TX
78758-5387
US

IV. Provider business mailing address

2200 PARK BEND DR BUILDING 2 SUITE 300
AUSTIN TX
78758-5387
US

V. Phone/Fax

Practice location:
  • Phone: 512-836-5665
  • Fax: 512-997-9092
Mailing address:
  • Phone: 512-836-5665
  • Fax: 512-997-9092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name: ILLIANA ECHOLS
Title or Position: MEDICAL ASSISTANT
Credential:
Phone: 512-836-5665