Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | L0421 | TX |
NPI | 1225035363 |
---|---|
Provider Name | Amin G Mery |
First Address | Austin, TX 78734 |
Second Address | Austin, TX 78734 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2005 |
Last Update Date | 21/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
189537702 | (05) | TX |
8CD502 | BCBS INDIVIDUAL (01) | TX |
H53530 | (02) |