Healthcare Provider Details

I. General information

NPI: 1699609883
Provider Name (Legal Business Name): ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 PARK BEND DR BLDG 1
AUSTIN TX
78758-5387
US

IV. Provider business mailing address

2200 PARK BEND DR BLDG 1 STE 401A
AUSTIN TX
78758-5387
US

V. Phone/Fax

Practice location:
  • Phone: 512-544-2575
  • Fax:
Mailing address:
  • Phone: 512-544-2575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAURA WIESS
Title or Position: CFO
Credential:
Phone: 512-544-5030