Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | N4066 | TX |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | N4066 | TX |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | N4066 | TX |
NPI | 1578595690 |
---|---|
Provider Name | Mary Catherine Sargent |
First Address | Austin, TX 78723-3077 |
Second Address | Austin, TX 78723-3077 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 18/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
208032701 | (05) | TX |
208032702 | MEDICAID CSHCN (01) | TX |
2080327-05 | (05) | TX |
2080327-06 | MEDICAID CSHCN ROT (01) | TX |
8CD812 | BCBS INDIVIDUAL # (01) | TX |