Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | K4600 | TX |
NPI | 1518063817 |
---|---|
Provider Name | Dr. Paul Vigo |
First Address | Austin, TX 78705-1143 |
Second Address | Austin, TX 78705-1143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 08/07/2007 |