Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | S0717 | TX |
NPI | 1306286166 |
---|---|
Provider Name | Dr. Christopher Lafargue |
First Address | Dallas, TX 75391-1242 |
Second Address | Fort Worth, TX 76104-2154 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2013 |
Last Update Date | 14/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
399144003 | (05) | TX |