Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | H5352 | TX |
NPI | 1427013200 |
---|---|
Provider Name | Bruce William Rajala |
First Address | Mckinney, TX 75070-8154 |
Second Address | Mckinney, TX 75071-7889 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 13/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
121154203 | (05) | TX |
E20220 | (02) |