Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1392 | TX |
Y | 222Z00000X | Podiatrist | 1392 | TX |
NPI | 1013900091 |
---|---|
Provider Name | Andrea K Rockett |
First Address | Houston, TX 77058-2538 |
Second Address | Houston, TX 77058-2538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2005 |
Last Update Date | 29/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101176903 | (05) | TX |
V72177 | (02) |