Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 670675 | TX |
NPI | 1043563406 |
---|---|
Provider Name | Calyn L Hughes |
First Address | Austin, TX 78754-5224 |
Second Address | Austin, TX 78723-2913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2012 |
Last Update Date | 23/10/2012 |