Basic Information
| Provider Information | |||||||||
| NPI: | 1356623011 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AUSTIN HOME HEART CARE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6429 CLAY ALLISON PASS | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787492702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5127397743 | ||||||||
| FaxNumber: | 5125326059 | ||||||||
| Practice Location | |||||||||
| Address1: | 6429 CLAY ALLISON PASS | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787492702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5127397743 | ||||||||
| FaxNumber: | 5125326059 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2011 | ||||||||
| LastUpdateDate: | 09/19/2011 | ||||||||
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| AuthorizedOfficialLastName: | BROWN | ||||||||
| AuthorizedOfficialFirstName: | ROSS | ||||||||
| AuthorizedOfficialMiddleName: | ANTHONY | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5127397743 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | RN ACNS-BC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SA2200X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Adult Health |
No ID Information.