Provider Demographics
NPI:1952547580
Name:AUSTIN COMMUNICATION STATION, INC.
Entity Type:Organization
Organization Name:AUSTIN COMMUNICATION STATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR AND CCC-SLP
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:K
Authorized Official - Last Name:BARTELT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:512-610-1190
Mailing Address - Street 1:3513 BANKSIDE ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-3031
Mailing Address - Country:US
Mailing Address - Phone:512-610-1190
Mailing Address - Fax:512-610-5951
Practice Address - Street 1:3513 BANKSIDE ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-3031
Practice Address - Country:US
Practice Address - Phone:512-610-1190
Practice Address - Fax:512-610-5951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-03
Last Update Date:2009-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102697235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty