Provider Demographics
NPI:1285135152
Name:AUSSA PHYSICIANS, PLLC
Entity type:Organization
Organization Name:AUSSA PHYSICIANS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GARLAND
Authorized Official - Middle Name:
Authorized Official - Last Name:BOECKING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-371-7478
Mailing Address - Street 1:1015 W 39TH 1/2 ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-4005
Mailing Address - Country:US
Mailing Address - Phone:512-371-7478
Mailing Address - Fax:512-371-3861
Practice Address - Street 1:1015 W 39TH 1/2 ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-4005
Practice Address - Country:US
Practice Address - Phone:512-371-7478
Practice Address - Fax:512-371-3861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-26
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty