Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | E7336 | TX |
NPI | 1558485979 |
---|---|
Provider Name | Dr. Betty J Edmond |
First Address | Austin, TX 78746-6263 |
Second Address | Austin, TX 78701-1926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 08/07/2007 |