Provider Demographics
NPI:1235399478
Name:AUSTIN OB-GYN ASSOCIATES PA
Entity Type:Organization
Organization Name:AUSTIN OB-GYN ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:GUZMAN
Authorized Official - Last Name:WINN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-391-0175
Mailing Address - Street 1:2911 MEDICAL ARTS ST
Mailing Address - Street 2:BLDG 3
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3376
Mailing Address - Country:US
Mailing Address - Phone:512-391-0175
Mailing Address - Fax:512-476-4078
Practice Address - Street 1:2911 MEDICAL ARTS ST
Practice Address - Street 2:BLDG 3
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3376
Practice Address - Country:US
Practice Address - Phone:512-391-0175
Practice Address - Fax:512-476-4078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7752207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00W029Medicare PIN