Provider Demographics
NPI:1538542899
Name:AUSTIN NEURO SPINE PLLC
Entity type:Organization
Organization Name:AUSTIN NEURO SPINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAM
Authorized Official - Middle Name:
Authorized Official - Last Name:VASUDEVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-640-0010
Mailing Address - Street 1:5300 BEE CAVE RD
Mailing Address - Street 2:BLDG 1 STE 220
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-640-0010
Mailing Address - Fax:512-256-8161
Practice Address - Street 1:5300 BEE CAVE RD
Practice Address - Street 2:BLDG 1 STE 220
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-640-0010
Practice Address - Fax:512-256-8161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-06
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty