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General NPI Number Information
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NPI Number | 1972918951
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Entity Type | Organization
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Legal Business Name | SURGERY SOUTHWEST AUSTIN PLLC
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Dates
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Enumeration Date | 06/27/2014
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Last Update Date | 02/18/2023
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Provider Practice Location Address
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Address Line | 5920 W WILLIAM CANNON DR BLDG 7-100
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City | AUSTIN
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State | TX
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Zip | 78749-1906
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Country | US
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Telephone | 512-615-3562
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Fax | 888-972-4864
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Provider Business Mailing Address
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Address Line | 5920 W WILLIAM CANNON DR BLDG 7-100
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City | AUSTIN
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State | TX
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Zip | 78749-1906
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Country | US
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Telephone | 512-615-3562
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Fax | 888-972-4864
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Authorized Official
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Title or Position | GENERAL SURGEON
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Name | LAUREN GAYLE ASH
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Credential | M.D.
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Telephone | 512-615-3562
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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 | P2371
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License Number State | TX
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