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General NPI Number Information
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NPI Number | 1295848257
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Entity Type | Organization
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Legal Business Name | AUSTIN NEUROSURGICAL AND SPINE INSTITUTE, PA
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 06/23/2009
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Provider Practice Location Address
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Address Line | 3724 EXECUTIVE CENTER DR STE G10
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City | AUSTIN
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State | TX
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Zip | 78731-1665
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Country | US
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Telephone | 512-345-5925
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Fax | 512-343-7113
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Provider Business Mailing Address
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Address Line | 3724 EXECUTIVE CENTER DR STE G10
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City | AUSTIN
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State | TX
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Zip | 78731-1665
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Country | US
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Telephone | 512-345-5925
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Fax | 512-343-7113
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES E HANSEN
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Credential | MD
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Telephone | 512-345-5925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA04626
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA05193
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | H2134
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License Number State | TX
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