Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | K3871 | TX |
NPI | 1033292123 |
---|---|
Provider Name | Dr. Christopher J Vesy |
First Address | Dallas, TX 75235-0629 |
Second Address | Dallas, TX 75246-1800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 16/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
043168602 | (05) | TX |
8S9971 | BCBS (01) | TX |
G88973 | (02) | TX |