Provider Demographics
NPI:1629139738
Name:CITY OF AUSTIN
Entity Type:Organization
Organization Name:CITY OF AUSTIN
Other - Org Name:HEALTH AND HUMAN SERVICES DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADOLFO
Authorized Official - Middle Name:MIGUEL
Authorized Official - Last Name:VALADEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD,, MPH
Authorized Official - Phone:512-972-5805
Mailing Address - Street 1:15 WALLER ST
Mailing Address - Street 2:SUITE 410
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-5240
Mailing Address - Country:US
Mailing Address - Phone:512-972-5805
Mailing Address - Fax:512-972-6225
Practice Address - Street 1:15 WALLER ST
Practice Address - Street 2:SUITE 410
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-5240
Practice Address - Country:US
Practice Address - Phone:512-972-5805
Practice Address - Fax:512-972-6225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6691261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPH0570Medicare UPIN
TXG61029Medicare UPIN