Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | G0228 | TX |
NPI | 1396718516 |
---|---|
Provider Name | Dr. Julius Henry Van Bavel |
First Address | Austin, TX 78731-3194 |
Second Address | Austin, TX 78731-3194 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 25/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B27233 | (02) |