SOUTH AUSTIN OB-GYN (NPI# 1013914993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013914993 |
| Entity Type | Organization |
| Organization Name | SOUTH AUSTIN OB-GYN |
| Practice Address |
4101 James Casey St Ste 330 Austin TX 78745-1145 |
| Practice Telephone | 5123734000 |
| Practice Fax Number | 5123734010 |
| Mailing Telephone | 5123734000 |
| Mailing Fax Number | 5123734010 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2007-10-12 |
| Authorized Official Name | DR. BENJAMIN D SUPNET (OWNER) |
| Authorized Official Telephone | 5123734000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | L3152 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
4101 JAMES CASEY ST STE 330 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78745-1145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205384096 | Rebecca Monti | Clinical Nurse Specialist | 4101 James Casey St, Suite 100, Austin, TX 78745-1145 | 2016-09-21 |
| 1720389596 | Texas Cardiac Arrythmia Pllc | Internal Medicine | 4101 James Casey St, Suite 300, Austin, TX 78745-3325 | 2010-11-10 |
| 1386971794 | Saul Benitez Jr. | Clinical Nurse Specialist | 4101 James Casey St, Suite 330, Austin, TX 78745-3325 | 2009-11-05 |
| 1093966178 | Katie Marie Good | Physician Assistant | 4101 James Casey St, Suite 100, Austin, TX 78745-3325 | 2008-10-07 |
| 1952559213 | Alex Esquivel, M.d., P.a. | Surgery | 4101 James Casey St, Ste 340, Austin, TX 78745-1145 | 2008-08-28 |
| 1972770303 | Texas Oncology Pa | Internal Medicine | 4101 James Casey St, Suite 100, Austin, TX 78745-3325 | 2008-05-14 |
| 1619196813 | Cynthia Marlin Lufschanowski | Pharmacist | 4101 James Casey St, Suite 100, Austin, TX 78745-3325 | 2007-04-25 |
| 1346316213 | Tops Pharmacy Services - Austin South | Pharmacist | 4101 James Casey St, Suite 100, Austin, TX 78745-3325 | 2006-11-24 |
| 1154416923 | Ryan Menzies Tierney | Radiology | 4101 James Casey St, Sutie 100, Austin, TX 78745-3325 | 2006-10-04 |
| 1497778229 | Punit Chadha | Internal Medicine | 4101 James Casey St, Suite 100, Austin, TX 78745-3325 | 2006-07-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617511 | Samantha Lynne Weston | Speech-Language Pathologist | 8515 Brodie Lane, Apt 2011, Austin, TX 78745 | 2020-10-26 |
| 1275172686 | Nithphaphone Tracy Bounsing | Registered Nurse | 4316 James Casey St, Building F, Suite 201, Austin, TX 78745 | 2020-01-02 |
| 1225685712 | Integrative Medical Group of Texas | General Practice | 6905 West Gate Blvd. Ste A, Austin, TX 78745 | 2019-08-20 |
| 1962971499 | Kimberly Angela Mancini | Social Worker | 5015 South Ih 35 Frontage Road, Austin, TX 78745 | 2018-11-14 |
| 1093223885 | Emma Rose Marek | Speech-Language Pathologist | 2700 Norfolk Drive, Austin, TX 78745 | 2018-01-16 |
| 1528586690 | Ashley Ellison | Social Worker | 4201 South Congress, Austin, TX 78745 | 2017-09-08 |
| 1134666761 | Carey Sebera | Counselor | 2812 Goldbridge Dr, Austin, TX 78745 | 2017-01-20 |
| 1932644507 | Maya Conlon | Social Worker | 2501 W. William Cannon Dr., Bldg 6 Ste. A, Austin, TX 78745 | 2017-01-05 |
| 1285189134 | 512 Physical Therapy and Golf Performance Center | Physical Therapist | 6800 Westgate Blvd, Suite 117, Austin, TX 78745 | 2016-08-22 |
| 1326401803 | Chris Winkley | Physical Therapist | 5510 S Ih 35 Frontage Rd #240, Austin, TX 78745 | 2016-04-01 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700408739 | Julie Marie Dorland | Obstetrics & Gynecology | Ut Austin Dell Medical School Obgyn Medical Park Tower, 1301 W 38th St, Suite 705, Austin, TX 78705 | 2020-05-13 |
| 1801450317 | Nicole Buchele | Obstetrics & Gynecology | Ut Austin Dell Medical School-obgyn, Medical Park Tower, 1301 W 38th St, Suite 705, Austin, TX 78705 | 2019-04-30 |
| 1841797636 | Corbin Anne Weaver | Obstetrics & Gynecology | Medical Park Tower, 1301 W. 38th St., Suite 705, Austin, TX 78705 | 2018-04-09 |
| 1326578477 | Mallory Monda | Obstetrics & Gynecology | 1301 W. 38th St., Suite 705, Ut Austin Dell Medical School-obgyn, Medical Park Tower, Austin, TX 78705-1016 | 2017-06-12 |
| 1528508389 | Whole Woman's Health Alliance | Obstetrics & Gynecology | 4100 Duval Rd Ste 201, Austin, TX 78759-3550 | 2017-02-27 |
| 1568841815 | Veronica Gonzalez | Obstetrics & Gynecology | 1313 Red River St., Suite A1 Ut Austin Dell Medical School Ob/gyn, Austin, TX 78701-1943 | 2015-05-20 |
| 1033506118 | Sharon Vaz | Obstetrics & Gynecology | 11111 Research Blvd Ste 475, Austin, TX 78759-5283 | 2015-04-16 |
| 1902207871 | Whole Woman's Health of New Mexico LLC | Obstetrics & Gynecology | 8401 N Ih 35, Suite 1a, Austin, TX 78753-5751 | 2014-09-10 |
| 1275953168 | Zoey Roberts | Obstetrics & Gynecology | 1313 Red River St., Ste A1, Umc At Brackenridge Utsw Austin Obgyn, Austin, TX 78701 | 2014-04-18 |
| 1316381148 | Kristin Sarah Tabor | Obstetrics & Gynecology | 12201 Renfert Way Ste 200, Austin, TX 78758-5368 | 2013-04-23 |
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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.