Provider Demographics
NPI:1558669895
Name:CTMF, INC.
Entity Type:Organization
Organization Name:CTMF, INC.
Other - Org Name:AUSTIN MEDICAL EDUCATION PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT AND COO
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROSLAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-324-5845
Mailing Address - Street 1:4900 MUELLER BLVD
Mailing Address - Street 2:DELL CHILDREN'S MEDICAL CENTER OF CENTRAL TEXAS
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3079
Mailing Address - Country:US
Mailing Address - Phone:201-805-7149
Mailing Address - Fax:
Practice Address - Street 1:4900 MUELLER BLVD
Practice Address - Street 2:DELL CHILDREN'S MEDICAL CENTER OF CENTRAL TEXAS
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3079
Practice Address - Country:US
Practice Address - Phone:201-805-7149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX791036282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren