# FLOSS 5TH AUSTIN PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FLOSS 5TH AUSTIN PLLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1992210132
- **Legal business name:** FLOSS 5TH AUSTIN PLLC
- **Authorized official:** AMANDA MARANDA (OPERATIONS MANAGER)
- **Authorized official phone:** (512) 221-7419

## Contact information

- **Practice address:** 1011 W 5TH ST STE 120, AUSTIN, TX 78703-5363
- **Practice address phone:** (512) 617-0101
- **Practice address fax:** (512) 505-8151
- **Mailing address:** 1011 W 5TH ST STE 120, AUSTIN, TX 78703-5363
- **Mailing address phone:** (512) 617-0101
- **Mailing address fax:** (512) 505-8151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/11/2017
- **Last updated:** 12/11/2017