Provider Demographics
NPI:1811922461
Name:HOSPITAL INTERNISTS OF AUSTIN, P.A.
Entity type:Organization
Organization Name:HOSPITAL INTERNISTS OF AUSTIN, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALYSA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MUTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-482-0045
Mailing Address - Street 1:7000 N. MOPAC
Mailing Address - Street 2:SUITE 420
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731
Mailing Address - Country:US
Mailing Address - Phone:512-482-0045
Mailing Address - Fax:512-476-9892
Practice Address - Street 1:7000 N. MOPAC
Practice Address - Street 2:SUITE 420
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731
Practice Address - Country:US
Practice Address - Phone:512-482-0045
Practice Address - Fax:512-476-9892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0798795-02Medicaid
TX0009BVMedicare PIN