Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | R9405 | TX |
N | 2084N0402X | Child Neurologist | R9405 | TX |
NPI | 1053679019 |
---|---|
Provider Name | Audrey Rosa Nath |
First Address | Dallas, TX 75265-4021 |
Second Address | Houston, TX 77030-2358 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2012 |
Last Update Date | 17/11/2021 |