Provider Demographics
NPI:1427063296
Name:AUSTIN HOSPITAL PHYSICIANS PA
Entity type:Organization
Organization Name:AUSTIN HOSPITAL PHYSICIANS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:CLITHEROE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-674-9021
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:SCHWERTNER
Mailing Address - State:TX
Mailing Address - Zip Code:76573-0010
Mailing Address - Country:US
Mailing Address - Phone:512-674-9021
Mailing Address - Fax:512-342-9949
Practice Address - Street 1:11211 TAYLOR DRAPER LN
Practice Address - Street 2:STE 202
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-3916
Practice Address - Country:US
Practice Address - Phone:512-674-9021
Practice Address - Fax:512-342-9949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
I9618OtherRETIRED RAILROAD MEDICARE
I9618OtherRETIRED RAILROAD MEDICARE