MEDICARE: CONCIERGE HEALTH OF AUSTIN PLLC

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	363L00000X	Nurse Practitioner
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1689466385
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONCIERGE HEALTH OF AUSTIN PLLC

Provider Business Mailing Address
First Line	:	3001 BEE CAVES RD STE 210
Second Line	:
City	:	ROLLINGWOOD
State	:	TX
Zip	:	78746-5590
Country	:	US
Telephone Number	:	512-434-0037
Fax Number	:

Provider Business Practice Location Address
First Line	:	3001 BEE CAVES RD STE 210
Second Line	:
City	:	ROLLINGWOOD
State	:	TX
Zip	:	78746-5590
Country	:	US
Telephone Number	:	512-434-0037
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	EMMANUEL LEE
Credential	:	MD
Telephone Number	:	512-434-0037

Provider Enumeration Date	:	05/19/2025
Last Update Date	:	05/21/2025

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