Healthcare Provider Details

I. General information

NPI: 1730126863
Provider Name (Legal Business Name): ST. DAVID'S HEALTHCARE PARTNERSHIP, L.P., LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 E 32ND ST
AUSTIN TX
78705-2703
US

IV. Provider business mailing address

919 E 32ND ST
AUSTIN TX
78705-2703
US

V. Phone/Fax

Practice location:
  • Phone: 512-476-7111
  • Fax: 512-404-8102
Mailing address:
  • Phone: 512-476-7111
  • Fax: 512-404-8102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVID W. MCKNIGHT
Title or Position: CFO
Credential:
Phone: 512-544-5030