Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | P5926 | TX |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | P5926 | TX |
NPI | 1871791558 |
---|---|
Provider Name | Marcelo Barros Antunes |
First Address | Austin, TX 78758-2604 |
Second Address | Austin, TX 78758-2604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2007 |
Last Update Date | 29/01/2021 |