Provider Demographics
NPI:1942693460
Name:AUVENSHINE, TIMOTHY (CST/CSFA)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:AUVENSHINE
Suffix:
Gender:M
Credentials:CST/CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9009 GREAT HILLS TRL
Mailing Address - Street 2:APT 228
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-7187
Mailing Address - Country:US
Mailing Address - Phone:970-819-7825
Mailing Address - Fax:
Practice Address - Street 1:9009 GREAT HILLS TRL
Practice Address - Street 2:APT 228
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-7187
Practice Address - Country:US
Practice Address - Phone:970-819-7825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-08
Last Update Date:2015-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant