Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 27611 | NE |
N | 207KA0200X | Allergist | 27611 | NE |
N | 208000000X | Pediatrician | 27611 | NE |
NPI | 1164795548 |
---|---|
Provider Name | Aubri Waters |
First Address | Fort Sam Houston, TX 78234-4504 |
Second Address | Fort Sam Houston, TX 78234-4504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2012 |
Last Update Date | 21/10/2021 |