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General NPI Number Information
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NPI Number | 1396486619
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Entity Type | Organization
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Legal Business Name | HARBOR HEALTH MEDICAL GROUP
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Dates
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Enumeration Date | 04/03/2022
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 500 N CAPITAL OF TEXAS HWY STE 125
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City | AUSTIN
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State | TX
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Zip | 78746-3302
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Country | US
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Telephone | 855-481-8375
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Fax |
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Provider Business Mailing Address
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Address Line | 3908 AVENUE B STE 204
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City | AUSTIN
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State | TX
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Zip | 78751-4515
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Country | US
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Telephone | 855-481-8375
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | RHONDA MUNDHENK
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Credential |
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Telephone | 855-418-8375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 261QA0005X
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Taxonomy Name | Ambulatory Family Planning Facility
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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