MEDICARE: HEART OF TEXAS MIDWIVES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife

General Provider Information

NPI Number	:	1093122913
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEART OF TEXAS MIDWIVES LLC

Provider Business Mailing Address
First Line	:	4006 CORTINA DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-4924
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1825 E 38TH 1/2 ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78722-1341
Country	:	US
Telephone Number	:	512-925-8354
Fax Number	:

Authorized Official
Title or Position	:	COOWNER
Name	:	MONIKA STONE
Credential	:	CPM, LM
Telephone Number	:	512-925-8354

Provider Enumeration Date	:	07/14/2014
Last Update Date	:	07/14/2014

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Directions to “HEART OF TEXAS MIDWIVES LLC ” Practice Location

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