Healthcare Provider Details
I. General information
NPI: 1780958470
Provider Name (Legal Business Name): MEDSPRING OF TEXAS, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/28/2012
Last Update Date: 05/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2120 GUADALUPE ST SUITE 100
AUSTIN TX
78705-5516
US
IV. Provider business mailing address
PO BOX 160247
AUSTIN TX
78716-0247
US
V. Phone/Fax
- Phone: 512-861-8030
- Fax: 512-485-7393
- Phone: 888-980-0505
- Fax: 512-485-7393
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JON
LESLIE
BELSHER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 512-402-6235