Provider Demographics
NPI:1174642656
Name:AUSTIN IVF, LP
Entity Type:Organization
Organization Name:AUSTIN IVF, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KAYLEN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:SILVERBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-610-7426
Mailing Address - Street 1:6500 N. MOPAC
Mailing Address - Street 2:BUILDING 3, SUITE 3102
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731
Mailing Address - Country:US
Mailing Address - Phone:512-610-7474
Mailing Address - Fax:512-610-7477
Practice Address - Street 1:6500 N. MOPAC
Practice Address - Street 2:BUILDING 3, SUITE 3102
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731
Practice Address - Country:US
Practice Address - Phone:512-610-7474
Practice Address - Fax:512-610-7477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
45D0505891291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherEIN
TX=========OtherTAX IDENTIFICATION NUMBER