Provider Demographics
NPI:1245290444
Name:AUSTIN WOMEN MDS
Entity type:Organization
Organization Name:AUSTIN WOMEN MDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARA
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MHA
Authorized Official - Phone:512-637-4968
Mailing Address - Street 1:12201 RENFERT WAY
Mailing Address - Street 2:SUITE 230
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5354
Mailing Address - Country:US
Mailing Address - Phone:512-637-4968
Mailing Address - Fax:512-637-4969
Practice Address - Street 1:12201 RENFERT WAY
Practice Address - Street 2:SUITE 230
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5354
Practice Address - Country:US
Practice Address - Phone:512-637-4968
Practice Address - Fax:512-637-4969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9417, L9110174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8C5882Medicare ID - Type UnspecifiedSHEILA PAREKH, MD
TXI18848Medicare UPIN
TXI19198Medicare UPIN
TX866395Medicare ID - Type UnspecifiedENZIE BRISKEY, MD