AUSTIN GERIATRIC SPECIALISTS, P.A. (NPI# 1376575886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376575886 |
| Entity Type | Organization |
| Organization Name | AUSTIN GERIATRIC SPECIALISTS, P.A. |
| Practice Address |
12731 Research Blvd Ste B200 Austin TX 78759 |
| Mailing Address |
1108 Lavaca St Ste 110-320 Austin TX 78701-2172 |
| Practice Telephone | 5124774088 |
| Practice Fax Number | 5124820390 |
| Mailing Telephone | 5124774088 |
| Mailing Fax Number | 5124820390 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2019-07-09 |
| Authorized Official Name | DR. LIAM M FRY (OWNER) |
| Authorized Official Telephone | 5124774088 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS OF TEXAS | 00049F | 01 |
| TX | TRAVELERS/MEDICARE RAILROAD | CI5689 | 01 |
| TX | 079678101 | 05 | |
| TX | MEDICARE RAILROAD | CG1751 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | AUSTIN GERIATRIC SPECIALISTS, P.A. | 12731 Research Blvd Ste 301c, Austin, TX 78701-4383 |
| Street Address |
12731 RESEARCH BLVD STE B200 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78759 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740211085 | Heather Leigh Herrington | Internal Medicine | 12731 Research Blvd Ste B200, Austin, TX 78759 | 2006-07-05 |
| 1003429986 | Ryan Webb | Clinical Nurse Specialist | 12731 Research Blvd Ste B200, Austin, TX 78759-4387 | 2020-08-28 |
| 1730791799 | Lynnea Elisabeth Edwards | Clinical Nurse Specialist | 12731 Research Blvd Ste B200, Austin, TX 78759-4387 | 2020-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677612 | Laurel Sunde | Nurse Practitioner | 11111 Research Blvd-ll2, Austin, TX 78759 | 2020-10-20 |
| 1558990242 | Sarah Ann Weier | Counselor | 8500 North Mopac Expressway, Austin, TX 78759 | 2020-04-03 |
| 1124672696 | Gabrielle Jade Hurley | Physical Therapist | 9333 Research Blvd Ste 400, Austin, TX 78759 | 2019-08-01 |
| 1730740671 | Jennifer Kraft | Behavior Technician | 9600 Great Hills Trail, Suite 150w, Austin, TX 78759 | 2019-06-21 |
| 1881199024 | Pediatric Home Healthcare, LLC | Home Health | 8501 N Mopac Expy Ste 410, Austin, TX 78759 | 2018-03-29 |
| 1679072870 | Sylvia Chen | Psychologist | 8400 N Mopac Expy Ste 302, Austin, TX 78759 | 2018-02-03 |
| 1215443064 | Greater Austin Urology, Pllc | Urology | 11673 Jollyville Rd Ste B101, Austin, TX 78759 | 2017-12-15 |
| 1831603042 | Jane A Dykes | Counselor | 9015 Mountain Ridge Dr., Houston Bldg., Ste. 200, Austin, TX 78759 | 2017-11-27 |
| 1134632706 | Gary Victor Friedman | Pharmacist | 4411 Spicewood Springs Road #1111, Austin, TN 78759 | 2017-11-06 |
| 1740720242 | Taylor Renee Cahill | Behavioral Analyst | 9901 North Capital of Texas Hwy, Austin, TX 78759 | 2017-03-02 |
| Find all providers in zip 78759 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841634854 | Michael L. Krol | Internal Medicine | 1108 Lavaca St Ste 110-320, Austin, TX 78701-2172 | 2013-04-20 |
| 1558530048 | Denise Rene Moraw | Internal Medicine | 9007 Rock Way Dr, Austin, TX 78736-7731 | 2008-02-28 |
| 1548319916 | Leslie Ludwig Cortes | Internal Medicine | 12401 Research Blvd Ste 220, Austin, TX 78759-2314 | 2007-01-09 |
| 1679598718 | Peggy M Russell | Internal Medicine | 1108 Lavaca St, 110-320, Austin, TX 78701-2172 | 2006-07-12 |
| 1669469235 | Mary S Maxwell | Internal Medicine | 4107 Medical Pkwy Ste 210, Austin, TX 78756-3738 | 2005-09-29 |
| 1780681163 | George Randolph Robison | Internal Medicine | 1000 Payton Gin Rd, Ste S, Austin, TX 78758-6766 | 2005-06-30 |
| 1558789487 | Joan E Lange | Internal Medicine | 1108 Lavaca St Ste 110-320, Austin, TX 78701-2172 | 2014-03-28 |
| 1063774602 | Steven K. Booton, M.d., P.a. | Internal Medicine | 720 W 34th St, Suite 100, Austin, TX 78705-1205 | 2012-06-11 |
| 1013247980 | Harden Clinical Services LLC | Internal Medicine | 3307 Northland Dr, Austin, TX 78731-4946 | 2009-12-28 |
| 1801055587 | Sarah Elizabeth Matt | Internal Medicine | 6448 E Hwy 290, Suite # D-103, Austin, TX 78723-1068 | 2008-06-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.