Basic Information
| Provider Information | |||||||||
| NPI: | 1689034993 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEDSPRING OF TEXAS, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3711 S MOPAC EXPWY | ||||||||
| Address2: | BLDG 2 STE 400 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787468014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5127659003 | ||||||||
| FaxNumber: | 5124857393 | ||||||||
| Practice Location | |||||||||
| Address1: | 2707 MILAM ST | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770063544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8889800505 | ||||||||
| FaxNumber: | 5124857393 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/29/2016 | ||||||||
| LastUpdateDate: | 02/29/2016 | ||||||||
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| AuthorizedOfficialLastName: | KADERLI | ||||||||
| AuthorizedOfficialFirstName: | CHERYL | ||||||||
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| AuthorizedOfficialTitleorPosition: | CONTRACTING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5127659003 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.