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
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