Healthcare Provider Details

I. General information

NPI: 1356608244
Provider Name (Legal Business Name): MEDSPRING OF TEXAS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2012
Last Update Date: 11/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11521 N FM 620 STE 100
AUSTIN TX
78726-1139
US

IV. Provider business mailing address

3711 S MOPAC EXPWY
AUSTIN TX
78746-8014
US

V. Phone/Fax

Practice location:
  • Phone: 512-402-6830
  • Fax: 512-485-7393
Mailing address:
  • Phone: 888-980-0505
  • Fax: 512-485-7393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHERYL LESLIE KADERLI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 512-765-9003