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General NPI Number Information
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NPI Number | 1245396381
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Entity Type | Organization
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Legal Business Name | AUSTIN MINOR EMERGENCY CLINIC
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Dates
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Enumeration Date | 12/30/2006
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Last Update Date | 09/10/2008
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Provider Practice Location Address
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Address Line | 1701 E 7TH ST
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City | AUSTIN
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State | TX
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Zip | 78702-2712
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Country | US
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Telephone | 512-473-2222
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Fax | 512-472-7549
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Provider Business Mailing Address
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Address Line | 1701 E 7TH ST
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City | AUSTIN
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State | TX
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Zip | 78702-2712
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Country | US
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Telephone | 512-473-2222
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Fax | 512-472-7549
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. WARREN E. THAMARUS
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Credential | M.D.
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Telephone | 512-473-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G1216
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License Number State | TX
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