Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist |
NPI | 1932867249 |
---|---|
Provider Name | Concetta Bormans |
First Address | Houston, TX 77008-1673 |
Second Address | Houston, TX 77008-1673 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2021 |
Last Update Date | 03/12/2021 |