Organization
THEOPHILUS S PAINTER JR MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE GATLIN (BILLING MGR)
(512) 259-9595
Entity
Organization
Contact information
Practice address
800 W 34TH ST, AUSTIN, TX 78705-1143
(512) 454-5821
(512) 260-8831
Mailing address
PO BOX 302186, AUSTIN, TX 78703-0037
(512) 454-5821
(512) 260-8831
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
B9692
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127396303
—
TX
Enumeration date
12/28/2007
Last updated
12/28/2007
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