Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | Q4749 | TX |
Y | 208600000X | Surgeon | Q4749 | TX |
N | 2086S0102X | Surgical Critical Care | Q4749 | TX |
NPI | 1306162805 |
---|---|
Provider Name | Aileen A. Ebadat |
First Address | Austin, TX 78745-1120 |
Second Address | Austin, TX 78745-1120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2010 |
Last Update Date | 08/03/2021 |