Organization
PRIMARY PHYSICIANS OF AUSTIN, P.A.
Active
Organization
PRIMARY PHYSICIANS OF AUSTIN, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG TOBIAS BERENT M.D. (PRESIDENT)
(512) 380-9441
Entity
Organization
Contact information
Practice address
4301 BURNET RD, SUITE A, AUSTIN, TX 78756-3317
(512) 380-9441
(512) 380-9410
Mailing address
4301 BURNET ROAD, SUITE A, AUSTIN, TX 78756-3317
(512) 380-9441
(512) 380-9410
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
K3988
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0020EV
BLUE CROSS GROUP #
TX
05
—
143675001
—
TX
Enumeration date
12/30/2006
Last updated
02/01/2011
Update your record
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