Jack Moncrief Group, Pa

LBN: Jack Moncrief Group, Pa
Jack Moncrief Group, Pa is an health care organization with primary practice located at 800 West 34Th Street Suite 101, Austin TX 78705. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Nephrology, which is considered as the primary health care specialty. Jack Moncrief Group, Pa can be contacted via phone (512) 485-7870, or through Moncrief, Jack Wesly via phone (512) 485-7870.

Contact Information

Primary practice address
800 West 34Th Street Suite 101 Austin TX 78705
Phone: (512) 485-7870
Fax: (512) 485-7876
Website:
Map and Directions
Authorized official contact:
Name: Moncrief, Jack Wesly Doctor of Medicine (MD)
Phone: (512) 485-7870

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X

Profile Details

NPI number 1194053496
LBN Legal business name Jack Moncrief Group, Pa
DBA Doing business as
Authorized official Moncrief, Jack Wesly Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 24th, 2009
Last updated Nov 24th, 2009 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194053496 NPPES
Texas MEDICAID 1311987-04

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