Healthcare Provider Details

I. General information

NPI: 1902688567
Provider Name (Legal Business Name): AUSTIN AREA MIDWIVES & CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 10/18/2023
Certification Date: 10/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W WILLIAM CANNON DR STE 503
AUSTIN TX
78745-5286
US

IV. Provider business mailing address

2500 W WILLIAM CANNON DR STE 503
AUSTIN TX
78745-5286
US

V. Phone/Fax

Practice location:
  • Phone: 512-243-8066
  • Fax:
Mailing address:
  • Phone: 512-619-9748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateNULL

VIII. Authorized Official

Name: REBECCA TAYLOR
Title or Position: OWNER / PRACTICE ADMINISTRATOR
Credential:
Phone: 512-619-9748