Provider Demographics
NPI:1669625901
Name:AUSTIN PODIATRY, PA
Entity Type:Organization
Organization Name:AUSTIN PODIATRY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:GOLF
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:512-448-3668
Mailing Address - Street 1:4310 JAMES CASEY ST
Mailing Address - Street 2:STE 3A
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1251
Mailing Address - Country:US
Mailing Address - Phone:512-448-3668
Mailing Address - Fax:512-448-4460
Practice Address - Street 1:4310 JAMES CASEY ST
Practice Address - Street 2:STE 3A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1251
Practice Address - Country:US
Practice Address - Phone:512-448-3668
Practice Address - Fax:512-448-4460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-30
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0582213ES0131X
TX1871213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty