Provider Demographics
NPI:1003099433
Name:EL BUEN SAMARITANO EPISCOPAL MISSION
Entity Type:Organization
Organization Name:EL BUEN SAMARITANO EPISCOPAL MISSION
Other - Org Name:EL BUEN SAMARITANO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAYLES
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:512-439-0745
Mailing Address - Street 1:7000 WOODHUE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745
Mailing Address - Country:US
Mailing Address - Phone:512-439-0745
Mailing Address - Fax:
Practice Address - Street 1:7000 WOODHUE DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5454
Practice Address - Country:US
Practice Address - Phone:512-439-0701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health