Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | Q8434 | TX |
Y | 208000000X | Pediatrician | Q8434 | TX |
NPI | 1588959704 |
---|---|
Provider Name | Bret Bostwick |
First Address | Houston, TX 77030-2608 |
Second Address | Houston, TX 77030-2608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2011 |
Last Update Date | 20/07/2016 |