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NPI 1376550418

NPI 1376550418 : DANA MIRKIN : AUSTIN, TX

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General NPI Number Information
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    NPI Number           |    1376550418
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    Entity Type          |    Individual 
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    Provider Name        |    DANA MIRKIN
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/02/2006
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    Last Update Date     |    09/11/2025
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Provider Practice Location Address
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    Address Line         |    918 E 32ND ST 
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78705-2704
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    Country              |    US
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    Telephone            |    512-404-8195
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    918 E 32ND ST 
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    City                 |    AUSTIN
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    State                |    TX
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    Zip                  |    78705-2704
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2083T0002X
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    Taxonomy Name        |    Medical Toxicology (Preventive Medicine) Physician
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    License Number       |    G7554
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    License Number State |    TX
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Taxonomy #2
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    Taxonomy Code        |    2083X0100X
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    Taxonomy Name        |    Occupational Medicine Physician
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    License Number       |    G7554
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    License Number State |    TX
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