Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 17232 | TX |
NPI | 1346340387 |
---|---|
Provider Name | Brian D Schaulin |
First Address | Friendswood, TX 77546-3820 |
Second Address | Friendswood, TX 77546-3820 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 10/07/2007 |