MEDICARE: GREENTREE HEALTH SURGICAL

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	207X00000X	Orthopaedic Surgery Physician		TX

General Provider Information

NPI Number	:	1639506546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREENTREE HEALTH SURGICAL

Provider Business Mailing Address
First Line	:	8900 SHOAL CREEK BLVD BLDG 301B
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-6810
Country	:	US
Telephone Number	:	512-419-8415
Fax Number	:	512-524-2251

Provider Business Practice Location Address
First Line	:	8900 SHOAL CREEK BLVD BLDG 301B
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78757-6810
Country	:	US
Telephone Number	:	512-419-8415
Fax Number	:	512-524-2251

Authorized Official
Title or Position	:	DIRECTOR, RCM DIVISION
Name	:	NATHALIE BLACKSTOCK
Credential	:
Telephone Number	:	512-323-6900

Provider Enumeration Date	:	10/09/2013
Last Update Date	:	10/09/2013

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Directions to “GREENTREE HEALTH SURGICAL ” Practice Location

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