Provider Demographics
NPI:1679528889
Name:ST. DAVID'S HEALTHCARE PARTNERSHIP, L.P., LLP
Entity Type:Organization
Organization Name:ST. DAVID'S HEALTHCARE PARTNERSHIP, L.P., LLP
Other - Org Name:ST. DAVID'S SOUTH AUSTIN MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-816-6111
Mailing Address - Street 1:901 W BEN WHITE BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-6903
Mailing Address - Country:US
Mailing Address - Phone:512-447-2211
Mailing Address - Fax:512-448-7326
Practice Address - Street 1:901 W BEN WHITE BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6903
Practice Address - Country:US
Practice Address - Phone:512-447-2211
Practice Address - Fax:512-448-7326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04300581Medicaid
IN200466320AMedicaid
450713OtherUNICARE
PA1015259170001Medicaid
0616440OtherAETNA/US HEALTHCARE
TX112717702Medicaid
300193OtherBLACK LUNG
TXHH0762OtherBLUE CROSS/MEDVIEW
3341335OtherHEALTHMARKET
376100300OtherUS DEPT OF LABOR
LA1707741Medicaid
5000164OtherUNITED HEALTHCARE
450713OtherSTERLING OPTION
FL913549900Medicaid
3341335OtherHEALTHMARKET
=========MOtherHUMANA
NE=========00Medicaid
FL913549900Medicaid