Provider Demographics
NPI:1952514101
Name:AUSTIN EXCLUSIVE MEDICAL SUPPLIES, L.L.C.
Entity Type:Organization
Organization Name:AUSTIN EXCLUSIVE MEDICAL SUPPLIES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-288-8532
Mailing Address - Street 1:PO BOX 90907
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78709-0907
Mailing Address - Country:US
Mailing Address - Phone:512-288-8532
Mailing Address - Fax:512-288-8533
Practice Address - Street 1:5900 SOUTHWEST PKWY
Practice Address - Street 2:BUILDING 2, SUITE 206
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-6202
Practice Address - Country:US
Practice Address - Phone:512-288-8532
Practice Address - Fax:512-288-8533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0073674332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6086360001Medicare NSC