NPI 1053096354

Prodigy Care Services LLC

Organisation Exclusive Provider Organization Austin, TX

Practice location

Address: 5900 Balcones Dr STE 100, Austin, TX 78731-4298
Phone: (713) 322-6667
Mailing address: PO Box 3161, Milwaukee, WI 53201-3161

Authorised official

Name: Paul Norkett
Title: Chief Operating Officer
Phone: (972) 800-7674

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

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Registry record

NPI: 1053096354
Entity type: Organization
NPI issued: 15 Jun 2023
Record last updated: 15 Jun 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.