Basic Information
| Provider Information | |||||||||
| NPI: | 1467542746 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HERRMAN | ||||||||
| FirstName: | KRISTY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1201 W 38TH ST | ||||||||
| Address2: | NEONATOLOGY OFFICE 8TH FLOOR | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123241086 | ||||||||
| FaxNumber: | 5123241089 | ||||||||
| Practice Location | |||||||||
| Address1: | 1201 W 38TH ST | ||||||||
| Address2: | NEONATOLOGY OFFICE 8TH FLOOR | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123241086 | ||||||||
| FaxNumber: | 5123241089 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/15/2006 | ||||||||
| LastUpdateDate: | 07/16/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080N0001X | L8729 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine | 2080N0001X | NC | N | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
No ID Information.