Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 550771 | TX |
NPI | 1407161763 |
---|---|
Provider Name | Anirudha Krishna Page |
First Address | Houston, TX 77030-2717 |
Second Address | Houston, TX 77030-2717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2010 |
Last Update Date | 11/08/2010 |