Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | P2533 | TX |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | P2533 | TX |
NPI | 1851540199 |
---|---|
Provider Name | Christopher Dwight Souder |
First Address | Austin, TX 78723-3078 |
Second Address | Austin, TX 78723-3078 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2008 |
Last Update Date | 07/10/2019 |