Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | G-2160 | TX |
N | 208D00000X | General Practice Physician | G-2160 | TX |
NPI | 1154351377 |
---|---|
Provider Name | Dr. David A Jolivet |
First Address | Houston, TX 77057-1501 |
Second Address | Houston, TX 77060-3409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 08/07/2007 |