Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | S6129 | TX |
NPI | 1083929269 |
---|---|
Provider Name | Abhishek Amar Bavle |
First Address | Austin, TX 78723-3078 |
Second Address | Austin, TX 78723-3078 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2010 |
Last Update Date | 06/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
417892301 | (05) | TX |