Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0402X | Child Neurologist | 120043 | TX |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP120043 | TX |
NPI | 1215217906 |
---|---|
Provider Name | Elizabeth Martin Cross |
First Address | Austin, TX 78757-7589 |
Second Address | Austin, TX 78757-7589 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2011 |
Last Update Date | 10/06/2021 |