Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 102879 | TX |
NPI | 1013060433 |
---|---|
Provider Name | Mr. David Mark Erben |
First Address | Austin, TX 78758-6497 |
Second Address | Austin, TX 78758-6497 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2007 |
Last Update Date | 08/07/2007 |