Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | T3009 | TX |
NPI | 1003247974 |
---|---|
Provider Name | Alyssa Walden |
First Address | Austin, TX 78705 |
Second Address | Austin, TX 78705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2013 |
Last Update Date | 17/09/2021 |