Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 01052929A | IN |
NPI | 1003965096 |
---|---|
Provider Name | Dr. Daniel S. Washburn |
First Address | El Paso, TX 79920-5001 |
Second Address | El Paso, TX 79920-5001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 08/07/2007 |