Provider Demographics
NPI:1487865465
Name:AUSTIN ASTHMA & LUNG ASSOC., PA
Entity Type:Organization
Organization Name:AUSTIN ASTHMA & LUNG ASSOC., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:POHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-423-3147
Mailing Address - Street 1:801 RANCH ROAD 620 S
Mailing Address - Street 2:STE 101
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734-5316
Mailing Address - Country:US
Mailing Address - Phone:512-263-4230
Mailing Address - Fax:512-263-0475
Practice Address - Street 1:801 RANCH ROAD 620 S
Practice Address - Street 2:STE 101
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-5316
Practice Address - Country:US
Practice Address - Phone:512-263-4230
Practice Address - Fax:512-263-0475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6077174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115717401Medicaid
TX802864Medicare PIN