Provider Demographics
NPI:1871773564
Name:AUSTIN'S FRIENDLY FAMILY MEDICINE, P.A.
Entity type:Organization
Organization Name:AUSTIN'S FRIENDLY FAMILY MEDICINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNECILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-377-2336
Mailing Address - Street 1:7600 BURNET RD STE 270
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1246
Mailing Address - Country:US
Mailing Address - Phone:512-377-2336
Mailing Address - Fax:
Practice Address - Street 1:7600 BURNET RD STE 270
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-1246
Practice Address - Country:US
Practice Address - Phone:512-377-2336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1972207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00527WOtherMEDICARE GROUP #
TX1982604161OtherINDIVIDUAL NPI
TX00527WOtherMEDICARE GROUP #
TX8B8052Medicare PIN