Provider Demographics
NPI:1417407651
Name:AASASTAT
Entity Type:Organization
Organization Name:AASASTAT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINSALATA
Authorized Official - Suffix:
Authorized Official - Credentials:CRNFA
Authorized Official - Phone:512-497-4092
Mailing Address - Street 1:9600 ESCARPMENT BLVD
Mailing Address - Street 2:SUITE 745, #200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-1982
Mailing Address - Country:US
Mailing Address - Phone:512-497-4092
Mailing Address - Fax:512-280-2207
Practice Address - Street 1:9600 ESCARPMENT BLVD
Practice Address - Street 2:SUITE 745, #200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-1982
Practice Address - Country:US
Practice Address - Phone:512-497-4092
Practice Address - Fax:512-280-2207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX621637163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1730260589OtherNPI TYPE 1
TX1346540440OtherNPI TYPE 2