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General NPI Number Information
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NPI Number | 1295813764
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Entity Type | Organization
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Legal Business Name | CENTRAL RIVER HEALTHCARE GROUP, PLLC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 04/11/2012
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Provider Practice Location Address
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Address Line | 1918 E RIVERSIDE DR SOUTH AUSTIN MEDICAL & HEALTH CLINIC
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City | AUSTIN
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State | TX
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Zip | 78741-1323
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Country | US
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Telephone | 512-326-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 8557 RESEARCH BLVD STE 128
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City | AUSTIN
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State | TX
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Zip | 78758-7855
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Country | US
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Telephone | 512-326-9200
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/MEDICAL DIRECTOR
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Name | LOANN THE TRINH
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Credential | D.O.
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Telephone | 512-326-9200
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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 | M7463
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M5120
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H4396
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | M2793
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 8016
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | L1765
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License Number State | TX
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Taxonomy #7
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | L1765
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License Number State | TX
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Taxonomy #8
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Taxonomy Code | 207PS0010X
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Taxonomy Name | Sports Medicine (Emergency Medicine) Physician
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License Number | L1765
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License Number State | TX
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