Basic Information
| Provider Information | |||||||||
| NPI: | 1508029521 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MYERS | ||||||||
| FirstName: | BYRON | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5508 PARKCREST DR | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787314905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124209900 | ||||||||
| FaxNumber: | 5124209944 | ||||||||
| Practice Location | |||||||||
| Address1: | 5508 PARKCREST DR | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787314905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124209900 | ||||||||
| FaxNumber: | 5124209944 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2008 | ||||||||
| LastUpdateDate: | 05/23/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 583751 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.