Provider Demographics
NPI:1851635452
Name:PEDIATRIC PARTNERS OF AUSTIN, P.A.
Entity Type:Organization
Organization Name:PEDIATRIC PARTNERS OF AUSTIN, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TERWELP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-345-6758
Mailing Address - Street 1:PO BOX 678053
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-8053
Mailing Address - Country:US
Mailing Address - Phone:512-241-0546
Mailing Address - Fax:512-241-0937
Practice Address - Street 1:3410 FAR WEST BLVD STE 130
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3167
Practice Address - Country:US
Practice Address - Phone:512-345-6758
Practice Address - Fax:512-345-1469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty