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General NPI Number Information
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NPI Number | 1417198565
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Entity Type | Organization
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Legal Business Name | AUSTIN ANESTHESIOLOGY ASSOCIATION
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Dates
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Enumeration Date | 03/19/2009
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Last Update Date | 03/19/2009
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Provider Practice Location Address
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Address Line | 6818 AUSTIN CENTER BLVD. SUITE 205
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City | AUSTIN
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State | TX
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Zip | 78731-3100
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Country | US
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Telephone | 512-349-9100
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Fax | 512-349-9133
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Provider Business Mailing Address
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Address Line | 6818 AUSTIN CENTER BLVD. SUITE 205
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City | AUSTIN
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State | TX
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Zip | 78731-3100
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Country | US
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Telephone | 512-349-9100
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Fax | 512-349-9133
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MARK T. MALONE
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Credential | M.D.
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Telephone | 512-349-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | G3580
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License Number State | TX
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