Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 34805 | TX |
NPI | 1083020523 |
---|---|
Provider Name | Dr. Patricia Robus |
First Address | Austin, TX 78705-1042 |
Second Address | Austin, TX 78705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2014 |
Last Update Date | 07/08/2019 |