Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 6078 | TX |
N | 111NR0200X | Radiology | 6078 | TX |
N | 213ER0200X | Radiology | 6078 | TX |
N | 111NR0400X | Rehabilitation Chiropractor | 6078 | TX |
NPI | 1508089855 |
---|---|
Provider Name | Dr. David Davidson O Iloani |
First Address | Houston, TX 77036-8020 |
Second Address | Houston, TX 77036-8020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C06038305 | (05) | TX |
U40327 | (02) | TX |