Healthcare Provider Details

I. General information

NPI: 1609057173
Provider Name (Legal Business Name): EXABLATE OF CENTRAL TEXAS, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2007
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 W 38TH ST STE 100
AUSTIN TX
78705-1128
US

IV. Provider business mailing address

1301 W 38TH ST STE 109
AUSTIN TX
78705-1010
US

V. Phone/Fax

Practice location:
  • Phone: 512-459-4276
  • Fax: 512-452-1353
Mailing address:
  • Phone: 512-533-4177
  • Fax: 512-452-7947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK D AKIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 512-533-4177