Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | L5466 | TX |
N | 207VX0000X | Obstetrician | L5466 | TX |
NPI | 1043249717 |
---|---|
Provider Name | Breno Loureiro Miguel |
First Address | Houston, TX 77076-4209 |
Second Address | Houston, TX 77076-4209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 14/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
154174001 | (05) | TX |
154174002 | (05) | TX |
154174003 | (05) | TX |
H71929 | (02) | TX |