Individual
DIANE BREWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
309 SHANT ST, AUSTIN, TX 78748-1612
(512) 971-5069
Mailing address
309 SHANT ST, AUSTIN, TX 78748-1612
(512) 971-5069
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1014823
TX
Other
Enumeration date
09/25/2020
Last updated
09/25/2020
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