Organization
NEW ALLIANCE OF INDEPENDENT
Active
Other names
Alliance Medical
Organization subpart
No
Provider details
NPI number
Authorized official
JAN BEAVER (DIRECTOR OF OPERATIONS)
(512) 345-2771
Entity
Organization
Contact information
Practice address
3267 BEE CAVE RD # 107-190, AUSTIN, TX 78746-6700
(512) 345-2771
(512) 345-6517
Mailing address
3267 BEE CAVE ROAD, 107-190, AUSTIN, TX 78746-6700
(512) 345-2771
(512) 345-6517
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0041318
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139682716
—
AR
05
—
1430439
—
LA
05
—
171934601
—
TX
05
—
200234860
—
OK
05
—
22985
—
OH
01
—
530714
BCBS
TX
01
—
7965083
AETNA PROVIDER NUMBER
TX
Enumeration date
08/30/2006
Last updated
11/28/2012
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