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Organization

AUXANOMEN A TEXAS NON PROFIT CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SUSAN KATHLEEN DUBOIS MD (MEDICAL DIRECTOR)
(512) 797-5169
Entity
Organization

Contact information

Practice address
2105 PARKER LN., ASTIN, TX 78741
(512) 797-5169
(512) 383-9225
Mailing address
2105 PARKER LN., AUSTIN, TX 78741
(512) 797-5169
(512) 383-9225

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
H61788
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
147296102
TX
Enumeration date
02/01/2012
Last updated
02/01/2012
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