Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0203X | Pediatric Critical Care Doctor | PA07002 | TX |
NPI | 1295038479 |
---|---|
Provider Name | Meghan Lane |
First Address | Austin, TX 78731-4280 |
Second Address | Austin, TX 78723-3079 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2010 |
Last Update Date | 06/02/2018 |