Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | P2212 | TX |
N | 207YP0228X | Pediatric Otolaryngology | 04-35115 | KS |
N | 207YP0228X | Pediatric Otolaryngology | 2010015930 | MO |
Y | 207YP0228X | Pediatric Otolaryngology | P2212 | TX |
NPI | 1790097087 |
---|---|
Provider Name | Dr. Daniel Charles Chelius JR. |
First Address | Houston, TX 77063-2100 |
Second Address | Houston, TX 77063-2100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2010 |
Last Update Date | 02/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
TXB153355 | (02) | TX |