Organization Name: | CHS TEXAS MEDICAL, P.A. |
NPI Number: | 1770893992 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STUART CLARK (EXECUTIVE VP) |
Mailing Address: | 701 East Parmer Lane Building 2 Austin |
State: | TX US |
Postal Code: | 78753 |
Phone Number: | 5127281461 |
Fax Number: | 5127244443 |
NPI Enumeration Date: | 10/21/2010 |
NPI Last Update Date: | 09/22/2014 |
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: |