PATIENT INFORMATION
South O. ffice. 5920 W. William Cannon Dr. Bldg 1 Ste 150. Austin, TX 78749. P . 512-441-9799. F . 512-441-9814 [Type text][Type text][Type text] ... and set over to Austin Pulmonary Consultants, PA all of my rights, title, and interest to my medical reimbursement benefits under my insurance policy. I authorize the release of any medical ... ................
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