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General NPI Number Information
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NPI Number | 1821504291
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Entity Type | Organization
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Legal Business Name | ADC PHYSICIANS PA
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Dates
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Enumeration Date | 12/21/2017
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Last Update Date | 12/21/2017
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Provider Practice Location Address
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Address Line | 12221 N MOPAC EXPY FL 4
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City | AUSTIN
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State | TX
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Zip | 78758-2401
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Country | US
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Telephone | 512-963-7503
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Fax |
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Provider Business Mailing Address
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Address Line | 12221 N MOPAC EXPY FL 4
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City | AUSTIN
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State | TX
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Zip | 78758-2401
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Country | US
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Telephone | 512-963-7503
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN OF THE BOARD
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Name | DR. JOHN VILLACIS
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Credential | MD
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Telephone | 512-709-4605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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