Provider Demographics
NPI:1689932162
Name:MEDICUS PARTNERS LLC
Entity Type:Organization
Organization Name:MEDICUS PARTNERS LLC
Other - Org Name:AUSTIN MIDTOWN AMBULATORY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GODBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-653-3459
Mailing Address - Street 1:901 W 38TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1164
Mailing Address - Country:US
Mailing Address - Phone:512-992-0027
Mailing Address - Fax:512-291-7562
Practice Address - Street 1:901 W 38TH ST STE 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1164
Practice Address - Country:US
Practice Address - Phone:512-992-0027
Practice Address - Fax:512-291-7562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain