Individual
MR. BRIAN WATABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3816 S 1ST ST, AUSTIN, TX 78704-7048
(512) 443-1311
(512) 406-6266
Mailing address
ARC ADMINISTRATION, 6210 US HWY 290, AUSTIN, TX 78723
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10821
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
366635601
—
TX
05
—
366635602
—
TX
Enumeration date
08/04/2016
Last updated
04/05/2022
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