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Organization
PREMIER AMBULATORY SURGERY OF AUSTIN LLP
Active
Organization
PREMIER AMBULATORY SURGERY OF AUSTIN LLP
Active
Other names
South Austin Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP A. CLENDENIN (PRESIDENT)
(615) 665-1823
Entity
Organization
Contact information
Practice address
4207 JAMES CASEY ST, SUITE 203, AUSTIN, TX 78745-1192
(512) 440-7894
(512) 440-1932
Mailing address
4207 JAMES CASEY ST, SUITE 203, AUSTIN, TX 78745-1192
(512) 440-7894
(512) 440-1932
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
000262
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092974702
—
TX
01
—
HH1236
BCBS
TX
Enumeration date
10/31/2006
Last updated
09/07/2023
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