Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 21848 | TX |
NPI | 1013040070 |
---|---|
Provider Name | Dr. Alexandre Ap Fleury |
First Address | Plano, TX 75024-3875 |
Second Address | Dallas, TX 75243-8259 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 08/07/2007 |