Individual
DR. SUE E YOUNG KNOLLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
515 S CAPITAL OF TEXAS HWY, STE 100, AUSTIN, TX 78746-4305
(512) 472-4011
(512) 472-5057
Mailing address
515 S CAPITAL OF TEXAS HWY, STE 100, AUSTIN, TX 78746-4305
(512) 472-4011
(512) 472-5057
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D6220
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043213721
NPI
TX
01
—
1154432508
GROUP NPI
TX
05
—
ZOOOL63V8
MEDICAID NUMBER
TX
Enumeration date
05/24/2005
Last updated
11/06/2007
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