Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | H2113 | TX |
NPI | 1114075280 |
---|---|
Provider Name | Allan David Duby |
First Address | Dallas, TX 75248-2961 |
Second Address | Dallas, TX 75248-2961 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 26/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C15406 | (02) | TX |