Provider Demographics
NPI:1720605116
Name:PHYSMEDICS LLC
Entity Type:Organization
Organization Name:PHYSMEDICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:CISCHKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-207-8757
Mailing Address - Street 1:10900 RESEARCH BLVD.
Mailing Address - Street 2:STE 160-C, #3
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5718
Mailing Address - Country:US
Mailing Address - Phone:214-207-8757
Mailing Address - Fax:
Practice Address - Street 1:10900 RESEARCH BLVD.
Practice Address - Street 2:STE 160-C, #3
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5718
Practice Address - Country:US
Practice Address - Phone:214-207-8757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty