| NPI | 1487988424 |
|---|---|
| Doing Business As | BODYLOGICMD OF AUSTIN |
| Entity Type | Organization |
| Authorized Contact | LISA GORN President 512-571-2223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: TX N3687) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX N3687) |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2014-05-27 |