Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | M0733 | TX |
NPI | 1740387281 |
---|---|
Provider Name | David M Godat |
First Address | Dallas, TX 75219-8604 |
Second Address | Dallas, TX 75243-3768 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2006 |
Last Update Date | 09/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Y44698 | (02) | TX |