Organization
PSA AMBULATORY SURGICAL CENTER OF SOUTH AUSTIN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA OPALAK (VP OF RCM)
(512) 485-7200
Entity
Organization
Contact information
Practice address
701 E FM 1626 STE 300, AUSTIN, TX 78748-2656
(855) 876-7246
(855) 277-5070
Mailing address
PO BOX 208373, DALLAS, TX 75320-8373
(512) 485-7208
(844) 364-8678
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130623
STATE OF TEXAS
TX
01
—
6F5700
MEDICARE PTAN
TX
Enumeration date
03/29/2022
Last updated
09/04/2024
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