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General NPI Number Information
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NPI Number | 1417174921
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Entity Type | Organization
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Legal Business Name | ROSEDALE FAMILY CARE PARTNERS, PA
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 5222 BURNET RD SUITE 200
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City | AUSTIN
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State | TX
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Zip | 78756-2430
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Country | US
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Telephone | 512-459-9889
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Fax | 512-389-2935
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Provider Business Mailing Address
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Address Line | 5222 BURNET RD SUITE 200
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City | AUSTIN
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State | TX
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Zip | 78756-2430
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Country | US
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Telephone | 512-459-9889
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Fax | 512-459-7373
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Authorized Official
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Title or Position | CLINIC COORDINATOR
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Name | KRYSTAL BUCHANAN
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Credential |
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Telephone | 512-459-9889
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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 |
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License Number State |
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