Provider Demographics
NPI:1245612225
Name:THE UNIVERSITY OF TEXAS AT AUSTIN
Entity Type:Organization
Organization Name:THE UNIVERSITY OF TEXAS AT AUSTIN
Other - Org Name:UT AUSTIN NURSING - WELLNESS CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE ASSOCIATE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-232-3727
Mailing Address - Street 1:2901 N IH 35 # 1.301
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78722-2322
Mailing Address - Country:US
Mailing Address - Phone:512-232-3727
Mailing Address - Fax:512-471-1455
Practice Address - Street 1:5301 ROSS RD
Practice Address - Street 2:#H
Practice Address - City:DEL VALLE
Practice Address - State:TX
Practice Address - Zip Code:78617-3288
Practice Address - Country:US
Practice Address - Phone:512-386-3335
Practice Address - Fax:512-386-3333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX845473261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service