Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 226714 | TX |
NPI | 1053474445 |
---|---|
Provider Name | Mrs. Sandra Jane Ransom |
First Address | Austin, TX 78704-3902 |
Second Address | Austin, TX 78704-7301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 08/07/2007 |