Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0122X | Plastic and Reconstructive Surgery | MD09780 | RI |
NPI | 1124145255 |
---|---|
Provider Name | Dr. Raymond Jackson Harshbarger III |
First Address | Austin, TX 78723-3080 |
Second Address | Austin, TX 78723-3080 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 25/10/2010 |