Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | ||
Y | 222Z00000X | Podiatrist | ||
N | 224P00000X | Prosthetist |
NPI | 1316452147 |
---|---|
Provider Name | Abigail Catherine Genet |
First Address | Dallas, TX 75235-8452 |
Second Address | Dallas, TX 75390-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2017 |
Last Update Date | 01/12/2017 |