Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | J3991 | TX |
NPI | 1033127022 |
---|---|
Provider Name | Charles P Biediger |
First Address | San Antonio, TX 78299-2679 |
Second Address | San Antonio, TX 78258-3227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H98554 | (02) |