Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | M0904 | TX |
Y | 208000000X | Pediatrician | M0904 | TX |
NPI | 1508946930 |
---|---|
Provider Name | Daryl Scott |
First Address | Houston, TX 77030-2316 |
Second Address | Houston, TX 77030-2316 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 08/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
178989301 | (05) | TX |
I50086 | (02) |