Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 26384 | TX |
N | 1223G0001X | General Practice | 0401412678 | VA |
N | 213EG0000X | General Practice | 0401412678 | VA |
NPI | 1093042111 |
---|---|
Provider Name | Dr. Sileshi B Assemu |
First Address | Austin, TX 78758-4013 |
Second Address | Austin, TX 78702-5240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2009 |
Last Update Date | 27/02/2017 |