Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | G4029 | TX |
NPI | 1033194634 |
---|---|
Provider Name | Dr. Craig H Lubin |
First Address | Austin, TX 78766-1597 |
Second Address | Austin, TX 78705-1900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2005 |
Last Update Date | 14/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B24502 | (02) | TX |