Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 0101042319 | VA |
NPI | 1003805623 |
---|---|
Provider Name | Catherine Emily Biersack |
First Address | San Antonio, TX 78259-2636 |
Second Address | Randolph A F B, TX 78150-4800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2005 |
Last Update Date | 08/07/2007 |