Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | M9548 | TX |
NPI | 1295816817 |
---|---|
Provider Name | Susan B Nunez |
First Address | Austin, TX 78723-3078 |
Second Address | Austin, TX 78723-3078 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 10/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
193236001 | (05) | TX |
G93919 | (02) |