Organization
AUSTIN FIVE STAR ER, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL CONNER (CEO)
(281) 209-8921
Entity
Organization
Contact information
Practice address
1700 ROUND ROCK AVENUE, ROUND ROCK, TX 78681
(281) 209-8921
(281) 209-8930
Mailing address
6300 LA CALMA DR, SUITE 200, AUSTIN, TX 78752-3843
(281) 209-8921
(281) 209-8930
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00M5M7
BLUE CROSS BLUE SHIELD OF TEXAS
TX
Enumeration date
11/12/2014
Last updated
03/02/2015
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