Provider Demographics
NPI:1629021845
Name:ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP
Entity Type:Organization
Organization Name:ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP
Other - Org Name:NORTH AUSTIN MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-901-2503
Mailing Address - Street 1:12221 N MO PAC EXPY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2401
Mailing Address - Country:US
Mailing Address - Phone:512-901-1000
Mailing Address - Fax:512-901-1995
Practice Address - Street 1:12221 N MO PAC EXPY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-2401
Practice Address - Country:US
Practice Address - Phone:512-901-1000
Practice Address - Fax:512-901-1995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
0494580OtherAETNA/US HEALTHCARE
1287369OtherUNITED HEALTHCARE
450809OtherWORKMANS COMP
CAXHSP42897Medicaid
165564800OtherUS DEPT OF LABOR
450809OtherUNICARE
621516424OtherHUMANA
MS07636250Medicaid
450809OtherSTERLING OPTION
TXHH0908OtherBLUE CROSS
TX094216103Medicaid
LA1729124Medicaid
3341065OtherHEALTHMARKET
TXHH0908OtherBLUE CROSS
450809OtherUNICARE