Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | D9212 | TX |
NPI | 1396729323 |
---|---|
Provider Name | Dr. Alvin Wayne Larkins |
First Address | Beaumont, TX 77702-1500 |
Second Address | Beaumont, TX 77702-1500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2005 |
Last Update Date | 26/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8F6494 | (02) | TX |