Organization Name: | AUSTIN PHYSICIAN ALLIANCE GROUP |
NPI Number: | 1437514510 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EDWARD MARROQUIN (CEO) |
Mailing Address: | 1106 Clayton Ln Suite 218e Austin |
State: | TX US |
Postal Code: | 787231066 |
Phone Number: | 5128764496 |
Fax Number: | 8663394149 |
NPI Enumeration Date: | 12/16/2015 |
NPI Last Update Date: | 12/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |