Provider Type Icon

PEACH STATE MEDICAL PRACTICE PC NPI 1083295638


NPI Information

NPI: 1083295638
Provider Name: PEACH STATE MEDICAL PRACTICE, PC
Classification: Clinic/Center - 261QA0006X
Entity Type: Organization

Specialization: Ambulatory Fertility Facility

CLIA Number: 45D2224370

Address:
202 W CESAR CHAVEZ ST
AUSTIN, TX
ZIP 78701
Phone: (855) 563-2639
Get Directions

PEACH STATE MEDICAL PRACTICE, PC is an ambulatory fertility facility clinic center in Austin, TX. The provider is a fertility facility, which may be licensed, registered, or certified in some states, that is not hospital-based, where services are provided at a fixed specific location. An Ambulatory Fertility Facility does not provide overnight accommodations. The following fertility procedures may be performed at an Ambulatory Fertility Facility: In Vitro Fertilization (IVF), Gamete Intrafallopian Transfer (GIFT), Embryo Transfer-Thaw (ET-T), Zygote Intrafallopian Transfer (ZIFT), Donor OOCYTE (DO) PEACH STATE MEDICAL PRACTICE, PC NPI is 1083295638. The provider is registered as an organization entity type.

The provider's business location address is:

202 W CESAR CHAVEZ ST
AUSTIN, TX
ZIP 78701-803
Phone: (855) 563-2639

The provider's authorized official is Fahimeh Sasan .
The authorized official title is Founding Obgyn and has the following contact phone number (855) 563-2639.

The CLIA number assigned to this NPI record is 45D2224370 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 4/15/2021 and was last updated on 4/15/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA0006XClinic/CenterAmbulatory Fertility FacilityYes
2261QF0050XClinic/CenterFamily Planning, Non-SurgicalNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.