Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | H4563 | TX |
NPI | 1013966290 |
---|---|
Provider Name | Brian E Monks |
First Address | Dallas, TX 75284-4658 |
Second Address | Temple, TX 76508-2707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 25/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0015DK | BLUE CROSS (01) | TX |
10030731 | AMERIGROUP (01) | TX |
140300821 | (05) | TX |
140300838 | (05) | TX |
140300839 | (05) | TX |
140300840 | (05) | TX |
2289979 | AETNA (01) | TX |
8BD724 | BCBS (01) | TX |
P00085983 | RAILROAD MEDICARE (01) | TX |