Provider Demographics
NPI:1881835247
Name:AUSTIN BONE & JOINT CLINIC A PROF A ASSOC
Entity Type:Organization
Organization Name:AUSTIN BONE & JOINT CLINIC A PROF A ASSOC
Other - Org Name:AUSTIN BONE AND JOINT CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PEARCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-477-6341
Mailing Address - Street 1:1015 E 32ND ST
Mailing Address - Street 2:STE 101
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-2700
Mailing Address - Country:US
Mailing Address - Phone:512-477-6341
Mailing Address - Fax:512-477-1148
Practice Address - Street 1:3001 BEE CAVES RD
Practice Address - Street 2:STE 220
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5590
Practice Address - Country:US
Practice Address - Phone:512-795-8812
Practice Address - Fax:512-795-8993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081856901Medicaid
TX081856901Medicaid
00C326Medicare PIN