Organization
PREMIER GYNECOLOGY OF AUSTIN
Active
Other names
Premier Gynecology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCREVEN TRACY EDGERTON M.D. (CEO)
(512) 299-5955
Entity
Organization
Contact information
Practice address
1010 W 9TH ST, AUSTIN, TX 78703-4924
(512) 299-5955
Mailing address
2416 SHIRE RIDGE DR, AUSTIN, TX 78732-2062
(512) 299-5955
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
M1080
TX
Other
Enumeration date
07/22/2010
Last updated
07/28/2010
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