Welcome to ATX Primary Care

Opening Hours : Monday to Friday - 7:30am to 4pm
  Contact : (512) 452-2506

Plan Your Visit

Set Your Appointment

Call (512) 452-2506 during regular business hours.

Office Hours: Monday – Friday – 7:30am to 4:00pm
Click to Call (512) 452-2506

Please advise our staff if you are being referred or have had a change in your insurance policy. Please have the following information available: Full name, date of birth, and insurance information.

 

Payment & Insurance Information

Please have your insurance card available while making your appointment. Please advise us of any of the following: Subsidiary Medicare program, Secondary Insurance policy, or Out-of-State policy. Our office staff will contact your insurance provider to verify all benefits. However, it is the patient’s responsibility to make sure that their policy is active and to be aware of any limitations of coverage. See our Billing & Insurance page for more info. Want to pay your bill online via credit card? You can also make a Secure Online Payment here.

Complete and Submit Our Office Forms

New Patient Registration Form

Or download this form and bring it with you

Medical Records Release TO ATX Primary Care

  • Date Format: MM slash DD slash YYYY
  • I Hereby Authorize Release of Information from:

  • This information may be sent to and used by the following individual or facility:

    ATX Primary Care
    Robert Raley, MD Aline C. Zeringue, ACNS-BC Mandy Mishra, ACNS-BC Eileen M. Costa, FNP-C
    2301 W. North Loop Blvd.
    Austin, TX 78756
    (P) 512-452-2506 (F) 512-371-0187
  • Date Format: MM slash DD slash YYYY

Or download this form and bring it with you

Medical Records Release FROM ATX Primary Care

Or download this form and bring it with you

Personal Representation Designation

  • Date Format: MM slash DD slash YYYY
  • The purpose of this form is to designate a patient’s Personal Representative(s) for discussion and disclosure of Personal Health Information (PHI.) Although this designation is a voluntary form, ATX Primary Care must have this on file if you would like a relative or another person to be able to communicate with ATX Primary Care on your behalf.

    Authorized Use and/or Disclosure

    I understand Personal Health Information (PHI), includes, but is not limited to, identification of treating providers of care, diagnoses, procedures, demographic information and medical information used to make payment decisions. If the designated Personal Representative(s) listed below is not a health care provider or other person subject to federal privacy laws, PHI may no longer be protected by those privacy laws and may by subject to re‐disclosure by the Personal Representative(s.) ATX Primary Care is not responsible should my Personal Representative(s) further disclose my protected PHI.

    I further understand that I have the right to limit the information that ATX Primary Care can release under this authorization. Limitations for disclosure have been identified below. By leaving this section blank, I am creating a “no limitation” on disclosure of Personal Health Information.

  • Expiration and Revocation

    I may revoke this authorization at any time, providing a written notice to ATX Primary Care. Any Revocation will only apply on and after the date ATX Primary Care receives the Revocation. Revocation will not affect any action ATX Primary Care has taken or any information that has already been released based upon prior authorizations. ATX Primary Care cannot cancel disclosures it made to the Personal Representative(s) before it received the Revocation.

  • Signature AND Authorization

  • Date Format: MM slash DD slash YYYY

Or download this form and bring it with you

*To view the PDF forms the Adobe Reader is required. If you are having issues viewing these files please download and install by clicking here.

 

Bring Any Medications & Previous Records

You are welcome to have your records faxed to our office at (512) 371-0187. However, to ensure the availability of your information and to prevent a delay in your visit, we recommend that you obtain a printed copy of your records and bring it with you. Please also bring any medications you are taking.

 

Map & Directions

From Mopac (Loop 1)

Take RM 2222/Northland Dr. toward the center of Austin.
Turn right onto Shoal Creek Blvd.
Turn left left onto Hancock Dr.
Turn left onto Woodview Ave.
Take the 1st right onto North Loop Blvd W.
Destination will be on the right.

From I-35

Take 2222/E Koenig Ln (to the west)
Turn left onto N Lamar Blvd.
Take the 3rd right onto N Loop Blvd (or) W North Loop Blvd.
Continue to follow W North Loop Blvd.
Destination will be on the left.