MEDICARE: CITY OF AUSTIN

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QC1500X	Community Health Clinic/Center
2	261QP0905X	State or Local Public Health Clinic/Center
3	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1568635803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF AUSTIN

Provider Business Mailing Address
First Line	:	15 WALLER ST FL 3
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78702-5240
Country	:	US
Telephone Number	:	512-972-4421
Fax Number	:	512-978-7556

Provider Business Practice Location Address
First Line	:	7500 BLESSING AVE
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78752-1716
Country	:	US
Telephone Number	:	512-972-5554
Fax Number	:	512-978-7556

Authorized Official
Title or Position	:	CUSTOMER SERVICE REPRESENTATIVE SR.
Name	:	JESSE HERNANDEZ
Credential	:
Telephone Number	:	512-972-4421

Provider Enumeration Date	:	04/08/2008
Last Update Date	:	02/20/2025

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Directions to “CITY OF AUSTIN ” Practice Location

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