Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | P0553 | TX |
NPI | 1033266846 |
---|---|
Provider Name | Kristie Young Borgman |
First Address | San Antonio, TX 78209-3715 |
Second Address | San Antonio, TX 78229-3735 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 24/01/2012 |