Provider Demographics
NPI:1407196314
Name:TRI COUNTY PRACTICE ASSOCIATION
Entity Type:Organization
Organization Name:TRI COUNTY PRACTICE ASSOCIATION
Other - Org Name:SPINE AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:STALLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-324-8300
Mailing Address - Street 1:3724 EXECUTIVE CENTER DR
Mailing Address - Street 2:SUITE G-10
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-1646
Mailing Address - Country:US
Mailing Address - Phone:512-345-5925
Mailing Address - Fax:
Practice Address - Street 1:715 DISCOVERY BLVD
Practice Address - Street 2:SUITE 407
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2287
Practice Address - Country:US
Practice Address - Phone:512-528-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies