Healthcare Provider Details

I. General information

NPI: 1710168661
Provider Name (Legal Business Name): AUSTIN ARTHRITIS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 07/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5656 BEE CAVE RD STE J200
WEST LAKE HILLS TX
78746-5280
US

IV. Provider business mailing address

5656 BEE CAVE RD STE J200
WEST LAKE HILLS TX
78746-5280
US

V. Phone/Fax

Practice location:
  • Phone: 512-732-2929
  • Fax: 512-732-2933
Mailing address:
  • Phone: 512-732-2929
  • Fax: 512-732-2933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberK0997
License Number StateTX

VIII. Authorized Official

Name: NICOLE KUCERA
Title or Position: OFFICE MANAGER
Credential:
Phone: 512-732-2929