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General NPI Number Information
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NPI Number | 1528092566
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Entity Type | Organization
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Legal Business Name | PEDIATRIC ASSOCIATES OF AUSTIN, P.A.
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 1600 W 38TH ST STE 100
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City | AUSTIN
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State | TX
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Zip | 78731-6404
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Country | US
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Telephone | 512-458-5323
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 W 38TH ST STE 100
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City | AUSTIN
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State | TX
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Zip | 78731-6404
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Country | US
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Telephone | 512-458-5323
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Fax | 512-458-2030
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Authorized Official
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Title or Position | BILLING
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Name | JANIS VASQUEZ
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Credential |
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Telephone | 512-563-5969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | TX
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