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Organization

AUSTIN CHILDREN'S CLINIC, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. REBECCA PAULINE MYERS (OFFICE MANAGER)
(512) 338-5130
Entity
Organization

Contact information

Practice address
11673 JOLLYVILLE RD, SUITE 104, AUSTIN, TX 78759-3933
(512) 338-5130
(512) 338-5112
Mailing address
11673 JOLLYVILLE RD, SUITE 104, AUSTIN, TX 78759-3933
(512) 338-5130
(512) 338-5112

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary

Other

Enumeration date
04/12/2007
Last updated
07/12/2007
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