Provider Demographics
NPI:1447985049
Name:PRICE, ISABEL OFELIA
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:OFELIA
Last Name:PRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ISABEL
Other - Middle Name:
Other - Last Name:GOMEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:717 HORSEBACK HOLW
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-2382
Mailing Address - Country:US
Mailing Address - Phone:512-975-0166
Mailing Address - Fax:
Practice Address - Street 1:6850 AUSTIN CENTER BLVD STE 225
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3293
Practice Address - Country:US
Practice Address - Phone:512-975-0166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-19
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL-302685174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty