Healthcare Provider Details

I. General information

NPI: 1730100694
Provider Name (Legal Business Name): SYMPHONY HEALTHCARE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 07/17/2024
Certification Date: 07/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 W 38TH ST STE C9
AUSTIN TX
78705-1137
US

IV. Provider business mailing address

PO BOX 269084
OKLAHOMA CITY OK
73126-9084
US

V. Phone/Fax

Practice location:
  • Phone: 512-454-3500
  • Fax: 512-590-5324
Mailing address:
  • Phone: 512-454-3500
  • Fax: 512-454-3515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHNNAE WHITE
Title or Position: FRONT OFFICE
Credential:
Phone: 512-454-3500