Provider Demographics
NPI:1821585340
Name:THRIVE PHYSICIANS PLLC
Entity Type:Organization
Organization Name:THRIVE PHYSICIANS PLLC
Other - Org Name:THRIVE MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:VENGHAUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-743-0360
Mailing Address - Street 1:2217 PARK BEND DR STE 210
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5674
Mailing Address - Country:US
Mailing Address - Phone:512-697-7090
Mailing Address - Fax:512-697-7097
Practice Address - Street 1:2217 PARK BEND DR STE 210
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5674
Practice Address - Country:US
Practice Address - Phone:512-697-7090
Practice Address - Fax:512-697-7097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-19
Last Update Date:2024-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ5594207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty