Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 36201 | SC |
N | 207X00000X | Orthopaedic Surgeon | 65913 | GA |
N | 207X00000X | Orthopaedic Surgeon | Q1326 | TX |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | Q1326 | TX |
NPI | 1447419619 |
---|---|
Provider Name | Dr. David Enrique Vizurraga |
First Address | San Antonio, TX 78258-4228 |
Second Address | Fort Sam Houston, TX 78234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 18/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
345644405 | (05) | TX |