Provider Demographics
NPI:1518017516
Name:KNISS MEDICAL, INC
Entity Type:Organization
Organization Name:KNISS MEDICAL, INC
Other - Org Name:THE SPRING, CENTER FOR NATURAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ELKE
Authorized Official - Middle Name:
Authorized Official - Last Name:KNISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-445-7373
Mailing Address - Street 1:707 SPOFFORD ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-1444
Mailing Address - Country:US
Mailing Address - Phone:512-445-7373
Mailing Address - Fax:
Practice Address - Street 1:809 SOUTH LAMAR BLVD.
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-1444
Practice Address - Country:US
Practice Address - Phone:512-445-7373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0595650001Medicare NSC