Provider Demographics
NPI:1477686145
Name:ASIIL, LLC
Entity Type:Organization
Organization Name:ASIIL, LLC
Other - Org Name:NEW BRAUNFELS RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMNISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CASTANEDA-CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-629-3614
Mailing Address - Street 1:705 LANDA ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-6172
Mailing Address - Country:US
Mailing Address - Phone:830-629-3614
Mailing Address - Fax:830-629-2438
Practice Address - Street 1:705 LANDA ST
Practice Address - Street 2:SUITE C
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-6172
Practice Address - Country:US
Practice Address - Phone:830-629-3614
Practice Address - Fax:830-629-2438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9273171W00000X
TXAP118284363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158613301Medicaid
TX158613302Medicaid
TX458999Medicare ID - Type UnspecifiedRURAL HEALTH CLINIC