Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 221254 | MA |
Y | 2080P0204X | Pediatric Emergency Doctor | M6709 | TX |
NPI | 1053300087 |
---|---|
Provider Name | Dr. Corrie Elizabeth Chumpitazi |
First Address | Pearland, TX 77584-9488 |
Second Address | Houston, TX 77030-2303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 11/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
188482702 | (05) | TX |