Provider Demographics
NPI:1053576181
Name:CITY OF AUSTIN
Entity type:Organization
Organization Name:CITY OF AUSTIN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER, IMMUNIZATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-972-5523
Mailing Address - Street 1:15 WALLER ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-5240
Mailing Address - Country:US
Mailing Address - Phone:512-972-5529
Mailing Address - Fax:
Practice Address - Street 1:7500 BLESSING AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-1716
Practice Address - Country:US
Practice Address - Phone:512-972-5176
Practice Address - Fax:512-972-6796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare