Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0207X | Pediatric Hematology-Oncologist | ME80084 | FL |
Y | 2080P0207X | Pediatric Hematology-Oncologist | N9167 | TX |
NPI | 1205852779 |
---|---|
Provider Name | Dr. Chatchawin Assanasen |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78207-3108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 22/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
220350701 | (05) | TX |
220350702 | CSHCN (01) | TX |