Provider Demographics
NPI:1053683185
Name:ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP
Entity Type:Organization
Organization Name:ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP
Other - Org Name:ROUND ROCK MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:WIESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-341-6404
Mailing Address - Street 1:2400 ROUND ROCK AVE
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4004
Mailing Address - Country:US
Mailing Address - Phone:512-255-6066
Mailing Address - Fax:512-238-1799
Practice Address - Street 1:2400 ROUND ROCK AVE
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4004
Practice Address - Country:US
Practice Address - Phone:512-255-6066
Practice Address - Fax:512-238-1799
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-06
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
45T718Medicare Oscar/Certification