Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | J77299 | TX |
NPI | 1275567620 |
---|---|
Provider Name | Dr. Suzan Jane Arizpe |
First Address | Austin, TX 78717-0033 |
Second Address | Austin, TX 78727-4599 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 18/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
165593802 | (05) | TX |
G18142 | (02) | TX |