Provider Demographics
NPI:1942296199
Name:HYPERBARIC MEDICINE CONSULTANTS PA
Entity Type:Organization
Organization Name:HYPERBARIC MEDICINE CONSULTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:MAILMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-544-5555
Mailing Address - Street 1:PO BOX 4268
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78765-4268
Mailing Address - Country:US
Mailing Address - Phone:512-544-5555
Mailing Address - Fax:512-544-8146
Practice Address - Street 1:900 E 30TH ST
Practice Address - Street 2:STE 109
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3326
Practice Address - Country:US
Practice Address - Phone:512-544-5555
Practice Address - Fax:512-544-8146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00U25EOtherBCBS
TX00U25EMedicare PIN