Basic Information
| Provider Information | |||||||||
| NPI: | 1699430298 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TEXAS ACUTE CARE SURGERY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3585 LOST CREEK BLVD | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787351445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5125382500 | ||||||||
| FaxNumber: | 5122441013 | ||||||||
| Practice Location | |||||||||
| Address1: | 4310 JAMES CASEY ST STE 3C | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787451120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5125382500 | ||||||||
| FaxNumber: | 5122441013 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2021 | ||||||||
| LastUpdateDate: | 11/08/2021 | ||||||||
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| AuthorizedOfficialLastName: | REYES | ||||||||
| AuthorizedOfficialFirstName: | MONICA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRACTICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5127446490 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| NPICertificationDate: | 11/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.