NPIMap

Organization Active NPI

MSK Clinic

  • Internal Medicine Physician
  • Austin, TX
National Provider Identifier
1992400501
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MSK CLINIC
Practice address
12129 RR 620 N Ste 610
Austin, TX 78750-1086
Phone
(512) 900-7800
Fax
(833) 463-1693
NPI assigned
Apr 3, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Authorized official

Name
Ibrahim Mansour, MDNPI 1578807590
Title
Doctor
Phone
(512) 900-7800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

12129 RR 620 N Ste 610
Austin, TX 78750-1086

Mailing address

12129 RR 620 N Ste 610
Austin, TX 78750-1086
Phone (512) 900-7800

National Provider Directory

National Provider Directory

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1992400501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12129 RR 620 N STE 610",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787501086",
            "telephone_number": "512-900-7800",
            "fax_number": "833-463-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12129 RR 620 N STE 610",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787501086",
            "telephone_number": "512-900-7800",
            "fax_number": "833-463-1693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MSK CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-03",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A",
        "authorized_official_last_name": "MANSOUR",
        "authorized_official_first_name": "IBRAHIM",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "512-900-7800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.