Provider Demographics
NPI:1609888676
Name:SOUTH AUSTIN ANESTHESIOLOGY, PA
Entity Type:Organization
Organization Name:SOUTH AUSTIN ANESTHESIOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:FINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-338-4986
Mailing Address - Street 1:8310 N CAPITAL OF TEXAS HWY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-1011
Mailing Address - Country:US
Mailing Address - Phone:513-342-2382
Mailing Address - Fax:512-342-2878
Practice Address - Street 1:901 W BEN WHITE BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6903
Practice Address - Country:US
Practice Address - Phone:512-342-2382
Practice Address - Fax:512-342-2878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX11084701Medicaid
TX00A80JMedicare ID - Type UnspecifiedPHYSICIAN GROUP
TX00C72CMedicare ID - Type UnspecifiedCRNA GROUP