Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | S7710 | TX |
Y | 207RP1001X | Pulmonary Disease | S7710 | TX |
NPI | 1023402229 |
---|---|
Provider Name | Ashley Annly Liou |
First Address | Arlington, TX 76014-2075 |
Second Address | Fort Worth, TX 76104-4215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2015 |
Last Update Date | 02/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S7710 | TEXAS MEDICAL LICENSE (01) | TX |