Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | AP136292 | TX |
NPI | 1528569753 |
---|---|
Provider Name | Christopher Henry Sutton |
First Address | Manor, TX 78653-4692 |
Second Address | Austin, TX 78701-1918 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2018 |
Last Update Date | 22/02/2018 |