Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | FTL 41699 | TX |
Y | 207T00000X | Neurosurgeon | M7439 | TX |
NPI | 1033159421 |
---|---|
Provider Name | Aaron Mohanty |
First Address | Houston, TX 77216-1088 |
Second Address | Houston, TX 77030-3000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 19/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
164962601 | (05) | TX |
8N8794 | BCBS (01) | TX |
I06774 | (02) | TX |