Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 2305 | TX |
Y | 222Z00000X | Podiatrist | 2305 | TX |
NPI | 1013981448 |
---|---|
Provider Name | Anie A Cherian |
First Address | Northbrook, IL 60065-0917 |
Second Address | Jourdanton, TX 78026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 22/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
395080001 | (05) | TX |
395080002 | (05) | TX |
395080003 | (05) | TX |
395080004 | (05) | TX |
U41206 | (02) |