MEDICARE: OAKBEND MEDICAL CENTER

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	313M00000X	Nursing Facility/Intermediate Care Facility	114618	TX
2	332B00000X	Durable Medical Equipment & Medical Supplies	1237440001	TX
3	314000000X	Skilled Nursing Facility	455599	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	HH2738	OTHER	TX	BCBS BLUE LINK
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457316176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAKBEND MEDICAL CENTER

Provider Business Mailing Address
First Line	:	2806 REAL ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78722-1715
Country	:	US
Telephone Number	:	512-474-1411
Fax Number	:	512-474-5401

Provider Business Practice Location Address
First Line	:	2806 REAL ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78722-1715
Country	:	US
Telephone Number	:	512-474-1411
Fax Number	:	512-474-5401

Authorized Official
Title or Position	:	CEO
Name	:	MR. JOSEPH FREUDENBERGER
Credential	:
Telephone Number	:	281-341-4881

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	06/22/2015

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Directions to “OAKBEND MEDICAL CENTER ” Practice Location

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