Organization
PREMIER AMBULATORY SURGERY OF AUSTIN LLP
Active
Other names
South Austin Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP A. CLENDENIN (PRESIDENT)
(615) 665-1823
Entity
Organization
Contact information
Practice address
4207 JAMES CASEY ST, SUITE 203, AUSTIN, TX 78745-1192
(512) 440-7894
(512) 440-1932
Mailing address
4207 JAMES CASEY ST, SUITE 203, AUSTIN, TX 78745-1192
(512) 440-7894
(512) 440-1932
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
000262
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092974702
—
TX
01
—
HH1236
BCBS
TX
Enumeration date
10/31/2006
Last updated
09/07/2023
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