Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | H9762 | TX |
NPI | 1184618597 |
---|---|
Provider Name | Brian James August |
First Address | El Paso, TX 79923-3157 |
Second Address | El Paso, TX 79912-6287 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 07/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
116114304 | (05) | TX |
T74789 | (02) |