# AUXANOMEN A TEXAS NON PROFIT CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861764219
- **Authorized official:** DR. SUSAN KATHLEEN DUBOIS MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (512) 797-5169

## Contact information

- **Practice address:** 2105 PARKER LN., ASTIN, TX 78741
- **Practice address phone:** (512) 797-5169
- **Practice address fax:** (512) 383-9225
- **Mailing address:** 2105 PARKER LN., AUSTIN, TX 78741
- **Mailing address phone:** (512) 797-5169
- **Mailing address fax:** (512) 383-9225

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | H61788 | TX | Yes |

## Other

- **Enumeration date:** 02/01/2012
- **Last updated:** 02/01/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 147296102 | — | TX |