Provider Demographics
NPI:1619982147
Name:ADULT CARE OF AUSTIN PA
Entity Type:Organization
Organization Name:ADULT CARE OF AUSTIN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SONSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-443-3577
Mailing Address - Street 1:7201 MANCHACA RD STE B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5259
Mailing Address - Country:US
Mailing Address - Phone:512-443-3577
Mailing Address - Fax:
Practice Address - Street 1:7201 MANCHACA RD STE B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5259
Practice Address - Country:US
Practice Address - Phone:512-443-3577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX083536501Medicaid
TX00K62VMedicare ID - Type Unspecified