Individual
ANA M AVALOS MISHAAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
825 E RUNDBERG LN STE B1, AUSTIN, TX 78753-4860
(512) 978-9600
(512) 978-9601
Mailing address
825 E RUNDBERG LN STE B1, AUSTIN, TX 78753-4860
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
N0616
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137345810
CSHCN GROUP
TX
01
—
140442852
MEDICAID GROUP
TX
01
—
1750369203
GROUP NPI
—
05
—
197453701
—
TX
01
—
197453702
CSHCN
TX
05
—
368699535B
—
GA
Enumeration date
07/05/2006
Last updated
10/02/2017
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