1932104577 NPI number — CENTRAL AUSTIN AMBULATORY SURGERY CENTER L.P.

Table of content: (NPI 1932104577)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932104577 NPI number — CENTRAL AUSTIN AMBULATORY SURGERY CENTER L.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL AUSTIN AMBULATORY SURGERY CENTER L.P.
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:
DBA CENTRAL PARK SURGERY CENTER
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:
1932104577
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
900 W 38TH ST
Provider Second Line Business Mailing Address:
STE 200
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78705-1129
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-323-2061
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 W 38TH ST
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78705-1129
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-323-2061
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/20/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DAY
Authorized Official First Name:
ERIC
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
512-439-5775

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  261QA1903X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QA1903X , with the licence number: ========= , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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