Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | L1912 | TX |
NPI | 1003822354 |
---|---|
Provider Name | Elizabeth C. Knapp |
First Address | Austin, TX 78723-1142 |
Second Address | Austin, TX 78731-3166 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 21/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
144774001 | (05) | TX |
144774003 | (05) | TX |
144774004 | (05) | TX |
144774005 | (05) | TX |