Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | G7173 | TX |
NPI | 1003056847 |
---|---|
Provider Name | Arthur J. Brock |
First Address | Dallas, TX 75231-4534 |
Second Address | Dallas, TX 75231-4534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2009 |
Last Update Date | 05/03/2009 |