South Austin Allergy and Wellness LLC

Primary specialty

Allergy PhysicianTaxonomy code 207KA0200X

Legal business name

SOUTH AUSTIN ALLERGY AND WELLNESS LLC

Practice address

11530 Manchaca Rd
Unit 2-a
Austin, TX 78748-2712

Phone

(512) 201-2668

NPI assigned

Jun 15, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Nelson

Title

Owner

Phone

(512) 680-6673

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467158400000",
    "number": "1629428164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11530 MANCHACA RD",
            "address_2": "UNIT 2-A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787482712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11530 MANCHACA RD",
            "address_2": "UNIT 2-A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787482712",
            "telephone_number": "512-201-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH AUSTIN ALLERGY AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-15",
        "last_updated": "2016-06-29",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-680-6673"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.