# CENTRAL RIVER HEALTHCARE GROUP, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295813764
- **Authorized official:** LOANN THE TRINH D.O. (PRESIDENT/MEDICAL DIRECTOR)
- **Authorized official phone:** (512) 326-9200

## Contact information

- **Practice address:** 1918 E RIVERSIDE DR, SOUTH AUSTIN MEDICAL & HEALTH CLINIC, AUSTIN, TX 78741-1323
- **Practice address phone:** (512) 326-9200
- **Mailing address:** 8557 RESEARCH BLVD STE 128, AUSTIN, TX 78758-7855
- **Mailing address phone:** (512) 326-9200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 8016 | TX | — |
| 207PS0010X | Sports Medicine (Emergency Medicine) Physician | L1765 | TX | Yes |
| 207Q00000X | Family Medicine Physician | H4396 | TX | — |
| 207Q00000X | Family Medicine Physician | M5120 | TX | — |
| 207Q00000X | Family Medicine Physician | M7463 | TX | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | L1765 | TX | — |
| 207R00000X | Internal Medicine Physician | L1765 | TX | — |
| 208D00000X | General Practice Physician | M2793 | TX | — |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 04/11/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00553V | BCBS OF TEXAS | TX |
| 05 | — | 161008101 | — | TX |