Provider Demographics
NPI:1770975435
Name:MEDSPRING OF TEXAS, PA
Entity type:Organization
Organization Name:MEDSPRING OF TEXAS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:KADERLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-765-9003
Mailing Address - Street 1:500 CANYON RIDGE DR
Mailing Address - Street 2:J350
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-1632
Mailing Address - Country:US
Mailing Address - Phone:512-792-4460
Mailing Address - Fax:512-485-7393
Practice Address - Street 1:2901 VIA FORTUNA
Practice Address - Street 2:STE 600
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-7565
Practice Address - Country:US
Practice Address - Phone:512-765-9003
Practice Address - Fax:512-410-6533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-04
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care