Provider Demographics
NPI:1255142071
Name:AUSTIN GASTROENTEROLGY
Entity type:Organization
Organization Name:AUSTIN GASTROENTEROLGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REFERRAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMYRAH
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:REFERRAL COORDINATOR
Authorized Official - Phone:512-454-4588
Mailing Address - Street 1:7951 SHOAL CREEK BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-7581
Mailing Address - Country:US
Mailing Address - Phone:512-454-4588
Mailing Address - Fax:
Practice Address - Street 1:7951 SHOAL CREEK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-7581
Practice Address - Country:US
Practice Address - Phone:512-454-4588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty