Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | J0909 | TX |
NPI | 1740251057 |
---|---|
Provider Name | Dr. John R. Austin |
First Address | Mcallen, TX 78503-1294 |
Second Address | Mcallen, TX 78503-1294 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 12/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
125167002 | (05) | TX |
5123008 | AETNA (01) | TX |
83C684 | BCBS (01) | TX |
F29554 | (02) | TX |