Provider Demographics
NPI:1811934649
Name:BRUSHY CREEK FAMILY PHYSICIANS PA
Entity type:Organization
Organization Name:BRUSHY CREEK FAMILY PHYSICIANS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AR/AP
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-218-8696
Mailing Address - Street 1:7200 WYOMING SPGS
Mailing Address - Street 2:SUITE #1500
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4303
Mailing Address - Country:US
Mailing Address - Phone:512-218-8696
Mailing Address - Fax:512-218-9532
Practice Address - Street 1:7200 WYOMING SPGS
Practice Address - Street 2:SUITE #1500
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4303
Practice Address - Country:US
Practice Address - Phone:512-218-8696
Practice Address - Fax:512-218-9532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CJ8946OtherRAILROAD MEDICARE
TX0030CVOtherBCBS
TX092289003Medicaid
TX00202KMedicare ID - Type UnspecifiedMEDICARE