Provider Demographics
NPI:1043097116
Name:AUSTIN MEDICINE
Entity Type:Organization
Organization Name:AUSTIN MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:HUTSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:737-400-6010
Mailing Address - Street 1:13341 W HWY 290 STE 251
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-9160
Mailing Address - Country:US
Mailing Address - Phone:737-400-6010
Mailing Address - Fax:
Practice Address - Street 1:13341 W HWY 290 STE 251
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-9160
Practice Address - Country:US
Practice Address - Phone:737-400-6010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty