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General NPI Number Information
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NPI Number | 1891745592
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Entity Type | Organization
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Legal Business Name | CAPITAL SURGEONS GROUP, PLLC
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 02/03/2021
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Provider Practice Location Address
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Address Line | 3705 MEDICAL PKWY STE 250
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City | AUSTIN
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State | TX
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Zip | 78705-1022
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Country | US
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Telephone | 512-302-1210
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Fax | 512-451-9752
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Provider Business Mailing Address
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Address Line | 3705 MEDICAL PKWY STE 250
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City | AUSTIN
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State | TX
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Zip | 78705-1022
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Country | US
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Telephone | 512-302-1210
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Fax | 512-451-9752
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Authorized Official
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Title or Position | CFO
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Name | SUSAN A. CLARKE
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Credential |
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Telephone | 512-334-1899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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