Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | L1624 | TX |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | L1624 | TX |
N | 208D00000X | General Practice Physician | L1624 | TX |
NPI | 1073673448 |
---|---|
Provider Name | Catalin D Jurnalov |
First Address | Galveston, TX 77555-5302 |
Second Address | Galveston, TX 77555-5302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 01/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
105420701 | (05) | TX |
G44793 | (02) | TX |