Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | P1925 | TX |
NPI | 1003041484 |
---|---|
Provider Name | Katherine Alison Sides |
First Address | Austin, TX 78704-4087 |
Second Address | San Marcos, TX 78666-7533 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2009 |
Last Update Date | 05/03/2019 |