Provider Demographics
NPI:1851519326
Name:ACCESS CO-MEDICAL CLINIC
Entity Type:Organization
Organization Name:ACCESS CO-MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AUGUSTIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BATLLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-447-2226
Mailing Address - Street 1:2919 MANCHACA RD STE 100-A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-4817
Mailing Address - Country:US
Mailing Address - Phone:512-447-2226
Mailing Address - Fax:512-447-2220
Practice Address - Street 1:2919 MANCHACA RD STE 100-A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-4817
Practice Address - Country:US
Practice Address - Phone:512-447-2226
Practice Address - Fax:512-447-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6324261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5662702OtherFIRST HEALTH
TX8U4580OtherBLUE CROSS BLUE SHIELD OF
TX5662702OtherFIRST HEALTH
TX8U4580OtherBLUE CROSS BLUE SHIELD OF
TX00759ZMedicare ID - Type Unspecified