Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | P3413 | TX |
NPI | 1770775728 |
---|---|
Provider Name | Kartik Pillutla |
First Address | Austin, TX 78723-3077 |
Second Address | Austin, TX 78723-3077 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2007 |
Last Update Date | 08/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
299825401 | (05) | TX |