Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 1533 | TX |
N | 222Z00000X | Podiatrist | 1533 | TX |
Y | 224P00000X | Prosthetist | 1533 | TX |
NPI | 1053666099 |
---|---|
Provider Name | David Kumba Lefors |
First Address | Texarkana, TX 75503-4650 |
Second Address | Texarkana, TX 75503-4650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2012 |
Last Update Date | 16/07/2012 |