Provider Demographics
NPI:1073702981
Name:AUSTIN CHILDREN'S CHEST ASSOCIATES II
Entity Type:Organization
Organization Name:AUSTIN CHILDREN'S CHEST ASSOCIATES II
Other - Org Name:AUSTIN CHILDREN'S CHEST ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:512-380-3800
Mailing Address - Street 1:3305 NORTHLAND DR STE 512
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4991
Mailing Address - Country:US
Mailing Address - Phone:512-380-9200
Mailing Address - Fax:512-380-9201
Practice Address - Street 1:3305 NORTHLAND DR STE 512
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4991
Practice Address - Country:US
Practice Address - Phone:512-380-9200
Practice Address - Fax:512-380-9201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric PulmonologyGroup - Single Specialty