Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 11393 | PR |
Y | 207W00000X | Ophthalmologist | N0511 | TX |
NPI | 1023058617 |
---|---|
Provider Name | Dr. Nadja Ivette Torres |
First Address | Austin, TX 78704-5703 |
Second Address | Austin, TX 78704-5703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 29/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
378961201 | (05) | TX |
BT4588058 | DEA (01) | TX |
G-12358 | (02) | PR |