Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | G7380 | TX |
N | 208600000X | Surgeon | G7380 | TX |
N | 2082S0105X | Plastic Hand Surgeon | G7380 | TX |
NPI | 1487661724 |
---|---|
Provider Name | Dr. David S Wishnew |
First Address | Austin, TX 78723-1172 |
Second Address | Austin, TX 78723-1172 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 02/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C23687 | (02) | |
P000FS557 | (05) | TX |