Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | N6174 | TX |
NPI | 1083669543 |
---|---|
Provider Name | Christopher Joseph Bettacchi |
First Address | Dallas, TX 75246-2060 |
Second Address | Dallas, TX 75246-2060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 21/07/2010 |