Organization
CHILDREN'S MEDICAL GROUP OF AUSTIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORRAINE EDRY SALEK POWELL MD (PHYSICIAN)
(512) 535-8243
Entity
Organization
Contact information
Practice address
631 W 38TH ST, AUSTIN, TX 78705-1250
(512) 451-5161
Mailing address
631 W 38TH ST, AUSTIN, TX 78705-1250
(512) 451-5161
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003043134
—
TX
05
—
1366776031
—
TX
05
—
1801460225
—
TX
05
—
1801896246
—
TX
Enumeration date
03/20/2023
Last updated
08/27/2024
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