Provider Type Icon

JACK MONCRIEF GROUP PA NPI 1194053496


NPI Information

NPI: 1194053496
Provider Name: JACK MONCRIEF GROUP, PA
Classification: Pediatrics - 2080P0210X
Entity Type: Organization

Specialization: Pediatric Nephrology

Address:
800 WEST 34TH STREET
SUITE 101
AUSTIN, TX
ZIP 78705
Phone: (512) 485-7870
Get Directions

JACK MONCRIEF GROUP, PA is a pediatric nephrology pediatrics in Austin, TX. The provider is a pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy. JACK MONCRIEF GROUP, PA NPI is 1194053496. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

800 WEST 34TH STREET
SUITE 101
AUSTIN, TX
ZIP 78705
Phone: (512) 485-7870
Fax: (512) 485-7876

The provider's authorized official is Jack Wesly Moncrief .
The authorized official title is Owner and has the following contact phone number (512) 485-7870.

The enumeration date for this NPI number is 11/24/2009 and was last updated on 11/24/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0210XPediatricsPediatric NephrologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10054BLMEDICARE PIN
21311987-04MEDICAIDTEXAS
3C19471MEDICARE UPINTEXAS

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: 4/28/2024

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.