Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | T2848 | TX |
NPI | 1407242308 |
---|---|
Provider Name | Alex Cruz |
First Address | Austin, TX 78759-4107 |
Second Address | Austin, TX 78759-4107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2015 |
Last Update Date | 25/10/2021 |