Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | D53336 | MD |
Y | 2080P0201X | Pediatric Allergist | R6439 | TX |
NPI | 1265482178 |
---|---|
Provider Name | Dr. Elizabeth Cotton Matsui |
First Address | Austin, TX 78712-1872 |
Second Address | Austin, TX 78723-3078 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 24/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
800701200 | (05) | MD |
G75055 | (02) | MD |