Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | P8471 | TX |
Y | 207NS0135X | Procedural Dermatology | P8471 | TX |
NPI | 1326200569 |
---|---|
Provider Name | Daniel Pablo Friedmann |
First Address | Austin, TX 78746-4721 |
Second Address | Austin, TX 78746-4721 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2008 |
Last Update Date | 06/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8EC419 | BCBS PROVIDER RECORD ID (01) | TX |