Individual
EILEEN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 W 38TH ST, AUSTIN, TX 78705-1006
(210) 324-1000
Mailing address
1201 W 38TH ST, AUSTIN, TX 78705-1006
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
824388
TX
Other
Enumeration date
07/06/2022
Last updated
07/06/2022
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