Provider Demographics
NPI:1609057173
Name:EXABLATE OF CENTRAL TEXAS, LTD.
Entity Type:Organization
Organization Name:EXABLATE OF CENTRAL TEXAS, LTD.
Other - Org Name:CENTRAL TEXAS EXABLATE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:AKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-533-4177
Mailing Address - Street 1:1301 W 38TH ST STE 109
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1010
Mailing Address - Country:US
Mailing Address - Phone:512-533-4177
Mailing Address - Fax:512-452-7947
Practice Address - Street 1:900 W 38TH ST STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1128
Practice Address - Country:US
Practice Address - Phone:512-459-4276
Practice Address - Fax:512-452-1353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center