Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | J4647 | TX |
N | 2080A0000X | Adolescent Medicine | J4647 | TX |
NPI | 1134187958 |
---|---|
Provider Name | Ceila Genio-Harding |
First Address | Dallas, TX 75243-1926 |
Second Address | Dallas, TX 75243-1926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 22/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
046074303 | (05) | TX |