Provider Demographics
NPI:1437728284
Name:AUSTIN OSTEOPATHIC MEDICINE, PLLC
Entity Type:Organization
Organization Name:AUSTIN OSTEOPATHIC MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SASKIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LYTLE-VIEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:512-638-2979
Mailing Address - Street 1:4611 BEE CAVES RD STE 308
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5284
Mailing Address - Country:US
Mailing Address - Phone:512-638-2979
Mailing Address - Fax:866-466-6438
Practice Address - Street 1:4611 BEE CAVES RD STE 308
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5284
Practice Address - Country:US
Practice Address - Phone:512-638-2979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS9345OtherMEDICAL LICENSE