Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | K9877 | TX |
NPI | 1184667123 |
---|---|
Provider Name | Dr. Martha I Pyron |
First Address | Austin, TX 78751-1101 |
Second Address | Austin, TX 78705-1134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 19/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1407092166 | GROUP NPI (01) | TX |