Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | M9480 | TX |
NPI | 1063605129 |
---|---|
Provider Name | Amit Mann |
First Address | Dallas, TX 75248-6426 |
Second Address | Dallas, TX 75208-2363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2007 |
Last Update Date | 11/07/2014 |