Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | M5713 | TX |
NPI | 1013994938 |
---|---|
Provider Name | Robert A. Friedman |
First Address | Austin, TX 78759-8660 |
Second Address | Austin, TX 78759-8660 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2005 |
Last Update Date | 27/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
241092 | (05) | AZ |
E78613 | (02) | AZ |