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General NPI Number Information
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NPI Number | 1245290444
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Entity Type | Organization
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Legal Business Name | AUSTIN WOMEN MDS
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12201 RENFERT WAY SUITE 230
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City | AUSTIN
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State | TX
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Zip | 78758-5354
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Country | US
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Telephone | 512-637-4968
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Fax | 512-637-4969
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Provider Business Mailing Address
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Address Line | 12201 RENFERT WAY SUITE 230
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City | AUSTIN
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State | TX
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Zip | 78758-5354
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Country | US
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Telephone | 512-637-4968
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Fax | 512-637-4969
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. KARA ASHLEY GREEN
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Credential | RN, MHA
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Telephone | 512-637-4968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | L9417, L9110
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License Number State | TX
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