Organization
HERZOG AUSTIN DOMAIN PC
Active
Other names
FLOSS
Organization subpart
No
Provider details
NPI number
Authorized official
CORTNEY BLACK (MANAGER)
(512) 617-0110
Entity
Organization
Contact information
Practice address
3310 W. BRAKER LN BLD. 1 #100, AUSTIN, TX 78758
(512) 617-0110
(512) 617-0111
Mailing address
3310 W. BRAKER LN BLD. 1 #100, AUSTIN, TX 78758
(512) 617-0110
(512) 617-0111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
TX
Other
Enumeration date
08/20/2013
Last updated
08/20/2013
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