Austin Infectious Disease Consultants, PA 080191
Organization Active NPI Infectious Disease Physician · Austin, TX
NPI 1205947710 · NPPES record last updated Dec 9, 2021
Key facts
- NPI
- 1205947710
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Infectious Disease Physician 207RI0200X
- Legal business name
- AUSTIN INFECTIOUS DISEASE CONSULTANTS, PA 080191
- Practice address
- 1301 W 38TH St Ste 403
Austin, TX 78705-1013 - Phone
- (512) 459-0301
- Fax
- (512) 459-9701
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Ariana Mares, CMM
- Title
- Practice Manager
- Phone
- (512) 593-7902
Practitioners 11
-
Jack Daulton Bissett, M.D.
-
Stephanie Lyons Cobb, D.O.
-
Lisa C Ellis, M.D.
-
James S. Stewart Evans, M.D.
-
Gregory Adrian Greenberg, AGCNS-BC
-
Brian Metzger, MD
-
Gayatri V Nair, M.D
-
Jason Schoneman, AGCNS
-
Matthew C Robinson, M.D.
-
John Todd Bagwell, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061018000243 | TX | Part B Supplier - Clinic/Group Practice | 9436155264 |
Receives reassigned benefits from 11 practitioners Practice locations: Austin, TX |
National Provider Directory
Locations
1301 W 38th St
Ste 404
Austin, TX 78705
Phone (512) 459-0301
1301 W 38th St
Ste 108
Austin, TX 78705
Phone (512) 459-0301
1301 W 38th St
Ste 403
Austin, TX 78705
Phone (512) 459-0301
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician |
207RI0200X | Yes |
Addresses
Primary practice location
1301 W 38TH St Ste 403
Austin, TX 78705-1013
Mailing address
1301 W 38TH St
Ste 403
Austin, TX 78705-1000
Phone (512) 459-0301
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1216884802 | Medicaid | TX | |
| 00F59E | Other | TX | BCBS |
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All providers in Austin, TX · Infectious Disease Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.