Provider Demographics
NPI:1184632986
Name:AUSTIN AREA OBSTETRICS, GYNECOLOGY & FERTILITY
Entity Type:Organization
Organization Name:AUSTIN AREA OBSTETRICS, GYNECOLOGY & FERTILITY
Other - Org Name:BRUMLEY, AKIN, SEEKER, PHILLIPS, URIBE, PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-533-4177
Mailing Address - Street 1:12200 RENFERT WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5614
Mailing Address - Country:US
Mailing Address - Phone:512-451-8211
Mailing Address - Fax:512-452-4095
Practice Address - Street 1:12200 RENFERT WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5614
Practice Address - Country:US
Practice Address - Phone:512-451-8211
Practice Address - Fax:512-452-4095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2009-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX083975503Medicaid
TX00M351Medicare UPIN