Provider Demographics
NPI:1629282140
Name:AUSTIN SOUTHWEST OBGYN
Entity Type:Organization
Organization Name:AUSTIN SOUTHWEST OBGYN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOUHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ASFOURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-444-1811
Mailing Address - Street 1:4316 JAMES CASEY ST BLDG F STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1109
Mailing Address - Country:US
Mailing Address - Phone:512-444-1811
Mailing Address - Fax:
Practice Address - Street 1:4316 JAMES CASEY ST BLDG F STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1109
Practice Address - Country:US
Practice Address - Phone:512-444-1811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8979207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00200HMedicare ID - Type Unspecified
TXE99436Medicare UPIN