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General NPI Number Information
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NPI Number | 1154799617
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Entity Type | Organization
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Legal Business Name | ATLIS ENTERPRISES LLC
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Dates
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Enumeration Date | 09/14/2015
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Last Update Date | 05/21/2023
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Provider Practice Location Address
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Address Line | 624 ALTEA DR
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City | LEANDER
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State | TX
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Zip | 78641
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Country | US
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Telephone | 210-827-9954
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Fax |
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Provider Business Mailing Address
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Address Line | 2208 RANCH ROAD 620 N APT 3103
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City | AUSTIN
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State | TX
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Zip | 78734-2817
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Country | US
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Telephone | 210-827-9954
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. PAUL ALLEN EDWARDS III
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Credential | MSN, APRN, FNP-C
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Telephone | 210-827-9954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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