Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | M8756 | TX |
NPI | 1023271301 |
---|---|
Provider Name | Parviz K Kavoussi |
First Address | Austin, TX 78745-1188 |
Second Address | Austin, TX 78745-1188 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2008 |
Last Update Date | 29/03/2011 |