Provider Demographics
NPI:1326686494
Name:CODE 1 CONCIERGE PLLC
Entity Type:Organization
Organization Name:CODE 1 CONCIERGE PLLC
Other - Org Name:CODE 1 CONCIERGE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITNEY-CASHIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-894-5050
Mailing Address - Street 1:14101 US 290 W
Mailing Address - Street 2:SUITE 400B
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-2445
Mailing Address - Country:US
Mailing Address - Phone:512-894-5050
Mailing Address - Fax:512-894-2201
Practice Address - Street 1:14101 US 290 W
Practice Address - Street 2:SUITE 400B
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-2445
Practice Address - Country:US
Practice Address - Phone:512-894-5050
Practice Address - Fax:512-894-2201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-19
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP4397OtherMEDICAL LICENSE