Provider Demographics
NPI:1639506082
Name:MEDSPRING PRIME, PA
Entity Type:Organization
Organization Name:MEDSPRING PRIME, PA
Other - Org Name:MEDSPRING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:BELSHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-402-6235
Mailing Address - Street 1:1335 E WHITESTONE BLVD
Mailing Address - Street 2:BUILDING P SUITE 100
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7598
Mailing Address - Country:US
Mailing Address - Phone:512-402-6840
Mailing Address - Fax:512-485-7393
Practice Address - Street 1:1250 S CAPITAL OF TEXAS HWY
Practice Address - Street 2:BUILDING 1 SUITE 500
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6446
Practice Address - Country:US
Practice Address - Phone:512-402-6233
Practice Address - Fax:512-831-4170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care