Organization
CENTRAL RIVER HEALTHCARE GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOANN THE TRINH D.O. (PRESIDENT/MEDICAL DIRECTOR)
(512) 326-9200
Entity
Organization
Contact information
Practice address
1918 E RIVERSIDE DR, SOUTH AUSTIN MEDICAL & HEALTH CLINIC, AUSTIN, TX 78741-1323
(512) 326-9200
Mailing address
8557 RESEARCH BLVD STE 128, AUSTIN, TX 78758-7855
(512) 326-9200
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
8016
TX
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
L1765
TX
207Q00000X
Family Medicine Physician
H4396
TX
207Q00000X
Family Medicine Physician
M5120
TX
207Q00000X
Family Medicine Physician
M7463
TX
207QS0010X
Sports Medicine (Family Medicine) Physician
L1765
TX
207R00000X
Internal Medicine Physician
L1765
TX
208D00000X
General Practice Physician
M2793
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00553V
BCBS OF TEXAS
TX
05
—
161008101
—
TX
Enumeration date
11/01/2006
Last updated
04/11/2012
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