Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 2006019872 | MO |
Y | 207RP1001X | Pulmonary Disease | 2006019872 | MO |
NPI | 1013094515 |
---|---|
Provider Name | Dr. James Andrew Driscoll |
First Address | Austin, TX 78705-1922 |
Second Address | Austin, TX 78705-1922 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 25/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H85996 | (02) |