1720033947 NPI number — ST. DAVIDS HEALTHCARE PARTNERSHIP, L.P., LLP

Table of content: (NPI 1720033947)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720033947 NPI number — ST. DAVIDS HEALTHCARE PARTNERSHIP, L.P., LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST. DAVIDS HEALTHCARE PARTNERSHIP, L.P., LLP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HEART HOSPITAL OF AUSTIN
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720033947
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
919 E 32ND ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78705-2703
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-476-7111
Provider Business Mailing Address Fax Number:
512-404-8102

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
919 E 32ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78705-2703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-476-7111
Provider Business Practice Location Address Fax Number:
512-404-8102
Provider Enumeration Date:
05/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HERRICK
Authorized Official First Name:
SETH
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
512-407-7510

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5000167 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 376099600 . This is a "US DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 450431 . This is a "STERLING OPTION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 300992 . This is a "BLACK LUNG" identifier . This identifiers is of the category "OTHER".
  • Identifier: HH0007 . This is a "BLUE CROSS/MEDVIEW" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 03283068 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 450431 . This is a "UNICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 450431 . This is a "WORKMANS COMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1708330 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 94160102 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0520298 . This is a "AETNA/US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3341349 . This is a "HEALTHMARKET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 017272200 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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