Provider Demographics
NPI:1144575119
Name:AUSTIN CITY MEDICAL CTR
Entity Type:Organization
Organization Name:AUSTIN CITY MEDICAL CTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:
Authorized Official - Last Name:OSSORIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-345-7900
Mailing Address - Street 1:11149 RESEARCH BLVD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5279
Mailing Address - Country:US
Mailing Address - Phone:512-345-7900
Mailing Address - Fax:512-345-7901
Practice Address - Street 1:11149 RESEARCH BLVD
Practice Address - Street 2:SUITE 360
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5279
Practice Address - Country:US
Practice Address - Phone:512-345-7900
Practice Address - Fax:512-345-7901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory