Healthcare Provider Details

I. General information

NPI: 1518017516
Provider Name (Legal Business Name): KNISS MEDICAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 SOUTH LAMAR BLVD.
AUSTIN TX
78704-1444
US

IV. Provider business mailing address

707 SPOFFORD ST
AUSTIN TX
78704-1444
US

V. Phone/Fax

Practice location:
  • Phone: 512-445-7373
  • Fax:
Mailing address:
  • Phone: 512-445-7373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. ELKE KNISS
Title or Position: CEO
Credential:
Phone: 512-445-7373