Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 40238 | KY |
N | 207T00000X | Neurosurgeon | M8421 | TX |
NPI | 1114913605 |
---|---|
Provider Name | Kristopher Michael Webb |
First Address | Austin, TX 78705-1804 |
Second Address | Austin, TX 78705-1804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 24/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I28933 | (02) |