| Symphony Healthcare Pa | |
|
711 W 38th St Ste C9 Austin TX 78705-1137 | |
| (512) 454-3500 | |
| (512) 590-5324 |
| Full Name | Symphony Healthcare Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 711 W 38th St Ste C9, Austin, Texas |
| Authorized Official Name and Position | Johnnae White (FRONT OFFICE) |
| Authorized Official Contact | 5124543500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Symphony Healthcare Pa Po Box 269084 Oklahoma City OK 73126-9084 Ph: (512) 454-3500 | Symphony Healthcare Pa 711 W 38th St Ste C9 Austin TX 78705-1137 Ph: (512) 454-3500 |
| NPI Number | 1730100694 |
|---|---|
| Provider Enumeration Date | 07/23/2006 |
| Last Update Date | 07/17/2024 |
| Medicare PECOS PAC ID | 1759300924 |
|---|---|
| Medicare Enrollment ID | O20051116000885 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730100694 | NPI | - | NPPES |
| 45D1045921 | Other | CLIA | |
| 0018MY | Other | BCBS GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Tuyet M Fannin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235126194 PECOS PAC ID: 7315970738 Enrollment ID: I20050915001125 |
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