Provider Demographics
NPI:1396028890
Name:AUSTIN CITY MEDICAL CENTER
Entity Type:Organization
Organization Name:AUSTIN CITY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-346-5600
Mailing Address - Street 1:11149 RESEARCH BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5279
Mailing Address - Country:US
Mailing Address - Phone:512-346-5600
Mailing Address - Fax:512-241-1554
Practice Address - Street 1:11149 RESEARCH BLVD STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5279
Practice Address - Country:US
Practice Address - Phone:512-346-5600
Practice Address - Fax:512-241-1554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty