Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | P8394 | TX |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | P8394 | TX |
NPI | 1316258460 |
---|---|
Provider Name | Amy E. Swan |
First Address | Houston, TX 77210-4439 |
Second Address | Houston, TX 77030-4009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2010 |
Last Update Date | 06/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
337465402 | (05) | TX |
337465403 | MEDICAID-CSHCN (01) | TX |
8LW417 | BCBS (01) | TX |