Provider Demographics
NPI:1639202443
Name:FS AUSTIN1, INC.
Entity Type:Organization
Organization Name:FS AUSTIN1, INC.
Other - Org Name:FOOT SOLUTIONS OF AUSTIN, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:B
Authorized Official - Last Name:TILNEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:CPED
Authorized Official - Phone:512-241-0051
Mailing Address - Street 1:8300 RESEARCH BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-8356
Mailing Address - Country:US
Mailing Address - Phone:512-241-0051
Mailing Address - Fax:512-241-0105
Practice Address - Street 1:8300 RESEARCH BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-8356
Practice Address - Country:US
Practice Address - Phone:512-241-0051
Practice Address - Fax:512-241-0105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6147940001Medicare NSC