Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 1159067 | TX |
NPI | 1104398262 |
---|---|
Provider Name | Austin Parker Kososki |
First Address | Houston, TX 77025-2367 |
Second Address | Houston, TX 77030-2358 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2018 |
Last Update Date | 28/01/2019 |