Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | AP108061 | TX |
NPI | 1295113538 |
---|---|
Provider Name | Chandra Garvey |
First Address | Richardson, TX 75082-2236 |
Second Address | Richardson, TX 75082-2236 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2015 |
Last Update Date | 06/05/2015 |