Provider Demographics
NPI:1386936433
Name:CENTRAL TEXAS WALK-IN CLINIC
Entity type:Organization
Organization Name:CENTRAL TEXAS WALK-IN CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:CSSBB
Authorized Official - Phone:832-878-0657
Mailing Address - Street 1:11139 N IH 35
Mailing Address - Street 2:SUITE120
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-3243
Mailing Address - Country:US
Mailing Address - Phone:512-614-2695
Mailing Address - Fax:512-614-2702
Practice Address - Street 1:11139 N IH 35
Practice Address - Street 2:SUITE120
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78753-3243
Practice Address - Country:US
Practice Address - Phone:512-614-2695
Practice Address - Fax:512-614-2702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty