Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | S7391 | TX |
NPI | 1457771438 |
---|---|
Provider Name | Adam Bender-Heine |
First Address | Harlingen, TX 78550-8472 |
Second Address | Harlingen, TX 78550-8472 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2014 |
Last Update Date | 12/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
414594801 | (05) | TX |
H08NB21201 | BCBS (01) | TX |