Individual
ANY JIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2409 UNIVERSITY AVE, AUSTIN, TX 78712-1112
(512) 417-1737
Mailing address
1901 RIO GRANDE ST APT 408, AUSTIN, TX 78705-5630
(501) 258-9511
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/30/2018
Last updated
03/30/2018
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