Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | K9253 | TX |
NPI | 1215991641 |
---|---|
Provider Name | Dr. Daniel A Deane |
First Address | San Antonio, TX 78209-5960 |
Second Address | San Antonio, TX 78209-5960 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 03/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
124617506 | TEXAS PROVIDER IDENTIFIER SPECIAL NEEDS (01) | TX |
124617507 | (05) | TX |
2619956 | (05) | OH |
B62824 | (02) | OH |