Healthcare Provider Details
I. General information
NPI: 1811502255
Provider Name (Legal Business Name): LOTUS COMMUNITY BIRTHING CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/12/2020
Last Update Date: 09/12/2020
Certification Date: 09/12/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13805 ANN PL APT B
AUSTIN TX
78728-7742
US
IV. Provider business mailing address
11403 HORNSBY ST
AUSTIN TX
78753-2627
US
V. Phone/Fax
- Phone: 512-736-4591
- Fax: 512-957-2702
- Phone: 512-736-4591
- Fax: 512-957-2702
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QB0400X |
| Taxonomy | Birthing Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VARSHNA
NARUMANCHI
Title or Position: OWNER,
Credential: LM
Phone: 512-736-4591