Provider Demographics
NPI:1578749305
Name:CITY OF AUSTIN
Entity Type:Organization
Organization Name:CITY OF AUSTIN
Other - Org Name:ATC HHSD IMMUNIZATION PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LURIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-972-5010
Mailing Address - Street 1:15 WALLER ST
Mailing Address - Street 2:STE 410
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-5240
Mailing Address - Country:US
Mailing Address - Phone:512-972-6216
Mailing Address - Fax:512-972-6225
Practice Address - Street 1:15 WALLER ST
Practice Address - Street 2:STE 410
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-5240
Practice Address - Country:US
Practice Address - Phone:512-972-6216
Practice Address - Fax:512-972-6225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local