Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | H1496 | TX |
NPI | 1326088469 |
---|---|
Provider Name | Dr. Brian F Humphreys |
First Address | Lufkin, TX 75904-3150 |
Second Address | Lufkin, TX 75904-3150 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 04/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00513Y | (02) | TX |
132380007 | (05) | TX |