Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | P6677 | TX |
N | 207YP0228X | Pediatric Otolaryngology | P6677 | TX |
NPI | 1487857660 |
---|---|
Provider Name | Timothy P. Mcevoy |
First Address | Austin, TX 78705-1027 |
Second Address | Austin, TX 78705-1027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2007 |
Last Update Date | 17/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
324267904 | (05) | TX |
324267905 | (05) | TX |