Provider Demographics
NPI:1740795772
Name:FLOSS 38TH AUSTIN LLC
Entity Type:Organization
Organization Name:FLOSS 38TH AUSTIN LLC
Other - Org Name:FLOSS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-615-0100
Mailing Address - Street 1:1005 W 38TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1042
Mailing Address - Country:US
Mailing Address - Phone:512-615-0100
Mailing Address - Fax:512-615-0121
Practice Address - Street 1:1005 W 38TH ST STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1042
Practice Address - Country:US
Practice Address - Phone:512-615-0100
Practice Address - Fax:512-615-0121
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLOSS 38TH AUSTIN LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental