Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | K7723 | TX |
NPI | 1225006893 |
---|---|
Provider Name | Dr. Elizabeth Louise Magnabosco |
First Address | San Antonio, TX 78207-3108 |
Second Address | San Antonio, TX 78207-3108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 05/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
117085405 | (05) | TX |
TXB126834 | (02) | TX |