Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 0000037157 | TN |
N | 208600000X | Surgeon | 0000037157 | TN |
N | 208200000X | Surgeon | A99985 | CA |
N | 208600000X | Surgeon | A99985 | CA |
Y | 2086S0120X | Pediatric Surgery | N6810 | TX |
NPI | 1417004383 |
---|---|
Provider Name | Mary Thomas Austin |
First Address | Houston, TX 77210-4439 |
Second Address | Houston, TX 77030-3000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 05/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
215704201 | (05) | TX |
215704203 (MDACC) | (05) | TX |
8CL916 | BCBS (MDACC) (01) | TX |
8CM171 | BCBS (01) | TX |
Z99258 | (02) |