Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | K9847 | TX |
Y | 208600000X | Surgeon | K9847 | TX |
N | 2086S0120X | Pediatric Surgery | K9847 | TX |
NPI | 1205828407 |
---|---|
Provider Name | Tory A. Meyer |
First Address | Austin, TX 78723-3078 |
Second Address | Austin, TX 78723-3078 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 02/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101751903 | (05) | TX |
112887805 | (05) | TX |
F71554 | (02) |