OrganizationAlphatelemedtexas(Alphatelemedtexas, Llc)Nurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address5900 Balcones Dr Ste 100, Austin, TX 78731-4298(703) 589-9964PECOS EnrollmentBased on the most recent information from CMS, provider Alphatelemedtexas does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:13 AM.Profile DetailsProvider ID1629670682Provider TypeOrganizationFull NameAlphatelemedtexasOther NameAlphatelemedtexas, LlcSubpartNoEnumeration Date11/13/2020Last Updated11/30/2023Contact InformationPractice LocationPractice Address5900 Balcones Dr Ste 100, Austin, TX 78731-4298Phone(703) 589-9964Fax(571) 252-7100Mailing LocationMailing Address10622 Runaway Ln, Great Falls, VA 22066-2420Phone(703) 589-9964Fax(571) 252-7100Authorized OfficialNameJiwani, Mubin (Owner)Phone(703) 589-9964Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted Issuer