Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | AP140816 | TX |
NPI | 1114480100 |
---|---|
Provider Name | Ashley Leger Trask |
First Address | Houston, TX 77008-2519 |
Second Address | Houston, TX 77024-2501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2019 |
Last Update Date | 08/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AP140816 | TEXAS BOARD OF NURSING (01) | TX |