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NPI Code Detail

MEDICARE: NORTH AUSTIN PERIODONTICS PA

MEDICARE: NORTH AUSTIN PERIODONTICS PA
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
11223P0300XPeriodontics

General Provider Information

NPI Number : 1710846191
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTH AUSTIN PERIODONTICS PA
Provider Business Mailing Address
First Line : 990 HESTERS CROSSING RD
Second Line :
City : ROUND ROCK
State : TX
Zip : 78681-8028
Country : US
Telephone Number : 512-341-2321
Fax Number : 512-341-2671
Provider Business Practice Location Address
First Line : 990 HESTERS CROSSING RD
Second Line :
City : ROUND ROCK
State : TX
Zip : 78681-8028
Country : US
Telephone Number : 512-341-2321
Fax Number : 512-341-2671
Authorized Official
Title or Position : OWNER
Name : KRIS OWENS
Credential : DDS
Telephone Number : 512-689-6252
Provider Enumeration Date : 01/20/2026
Last Update Date : 01/20/2026

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Directions to “NORTH AUSTIN PERIODONTICS PA ” Practice Location

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