Provider Demographics
NPI:1881648863
Name:ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP
Entity Type:Organization
Organization Name:ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP
Other - Org Name:NORTH AUSTIN MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-901-2503
Mailing Address - Street 1:12221 N MO PAC EXPY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2401
Mailing Address - Country:US
Mailing Address - Phone:512-901-1000
Mailing Address - Fax:512-901-1995
Practice Address - Street 1:12221 N MO PAC EXPY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-2401
Practice Address - Country:US
Practice Address - Phone:512-901-1000
Practice Address - Fax:512-901-1995
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-22
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========022OtherTRICARE SC
=========022OtherTRICARE SC