Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 3073 | TX |
NPI | 1487159570 |
---|---|
Provider Name | Dr. Christian Tharale Morrison |
First Address | Temple, TX 76508-0001 |
Second Address | Murphy, TX 75094-4634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2018 |
Last Update Date | 14/07/2021 |