Organization
MEDICAL PARK ORTHOPAEDIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID W. MANNING (ADMINISTRATOR)
(512) 454-4561
Entity
Organization
Contact information
Practice address
1301 W 38TH ST, STE. 102, AUSTIN, TX 78705-1000
(512) 454-4561
(512) 467-2906
Mailing address
1301 W 38TH ST, STE. 102, AUSTIN, TX 78705-1000
(512) 454-4561
(512) 467-2906
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00J744
BCBS
TX
01
—
0587470001
PALMETTO GBA
TX
01
—
CC8254
RAILROAD MEDICARE
TX
Enumeration date
07/01/2006
Last updated
08/22/2020
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