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General NPI Number Information
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NPI Number | 1003887845
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Entity Type | Organization
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Legal Business Name | AUSTIN ENDOSCOPY CENTER II, LP
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 12/22/2009
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Provider Practice Location Address
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Address Line | 4310 JAMES CASEY ST 4B
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City | AUSTIN
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State | TX
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Zip | 78745-1120
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Country | US
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Telephone | 512-532-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 4310 JAMES CASEY ST 4B
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City | AUSTIN
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State | TX
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Zip | 78745-1120
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Country | US
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Telephone | 512-532-8000
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. BRUCE A LEVY
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Credential | MD, JD
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Telephone | 512-420-0186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | ASC108
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License Number State | TX
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