Provider Demographics
NPI:1083245070
Name:CITY OF AUSTIN
Entity Type:Organization
Organization Name:CITY OF AUSTIN
Other - Org Name:CITY OF AUSTIN OFFICE OF CHIEF MEDICAL OFFICER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:LEGGIO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:512-978-0000
Mailing Address - Street 1:4201 ED BLUESTEIN BLVD STE S2505
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78721-2909
Mailing Address - Country:US
Mailing Address - Phone:512-978-0000
Mailing Address - Fax:
Practice Address - Street 1:4201 ED BLUESTEIN BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78721-2909
Practice Address - Country:US
Practice Address - Phone:512-978-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF AUSTIN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-29
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty