Provider Demographics
NPI:1710768064
Name:HEINRICH-JOSEY ORTHOPAEDICS
Entity Type:Organization
Organization Name:HEINRICH-JOSEY ORTHOPAEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-303-8803
Mailing Address - Street 1:4611 GUADALUPE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-2928
Mailing Address - Country:US
Mailing Address - Phone:512-476-2830
Mailing Address - Fax:512-476-2832
Practice Address - Street 1:5329 SERENE HILLS DR STE 202
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738-1259
Practice Address - Country:US
Practice Address - Phone:512-476-2830
Practice Address - Fax:512-476-2832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty