Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | K1138 | TX |
NPI | 1063408128 |
---|---|
Provider Name | Dr. Robert J. Wozniak |
First Address | Austin, TX 78727-3437 |
Second Address | Austin, TX 78758-5387 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
045077702 | (05) | TX |
045077705 | (05) | TX |
060064378 | MEDICARE RAILROAD (01) | TX |