Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | D1751 | TX |
NPI | 1033167382 |
---|---|
Provider Name | Dr. David Clay Mullins |
First Address | San Antonio, TX 78229-3641 |
Second Address | San Antonio, TX 78229-3641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F95286 | (02) | TX |