Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A81571 | CA |
Y | 207X00000X | Orthopaedic Surgeon | Q3646 | TX |
NPI | 1013960921 |
---|---|
Provider Name | Dr. Kevin J. Bozic |
First Address | Austin, TX 78723-3092 |
Second Address | Austin, TX 78705-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 29/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A815710 | (05) | CA |
351396201 | (05) | TX |
G77233 | (02) | CA |