Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | Q5991 | TX |
N | 207YS0123X | Facial Plastic Surgeon | Q5991 | TX |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | Q5991 | TX |
NPI | 1194823096 |
---|---|
Provider Name | Dr. Minas Spiros Constantinides |
First Address | Austin, TX 78756-0002 |
Second Address | Austin, TX 78756-0002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 05/02/2019 |