Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | N8953 | TX |
N | 208600000X | Surgeon | N8953 | TX |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | N8953 | TX |
NPI | 1114056215 |
---|---|
Provider Name | Carlos Miguel Mery |
First Address | Austin, TX 78723-3079 |
Second Address | Austin, TX 78723-3079 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 26/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
701973 | MEDICARE (01) | TX |