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Organization
NORTH AUSTIN FAMILY MEDICINE, PA
Active
Organization
NORTH AUSTIN FAMILY MEDICINE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN BANGSTON M.D. (PRESIDENT)
(512) 338-5150
Entity
Organization
Contact information
Practice address
11671 JOLLYVILLE RD, SUITE 203, AUSTIN, TX 78759-4139
(512) 338-5150
(512) 338-5155
Mailing address
11671 JOLLYVILLE RD, SUITE 203, AUSTIN, TX 78759-4139
(512) 338-5150
(512) 338-5155
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K7990
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8A2720
BCBS
TX
Enumeration date
05/21/2007
Last updated
05/01/2009
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