Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 6137 | TX |
N | 111NS0005X | Chiropractic Sports Physician | 2102 | TX |
NPI | 1215038641 |
---|---|
Provider Name | Dr. David Ray Maske |
First Address | San Antonio, TX 78240-1218 |
Second Address | San Antonio, TX 78240-1218 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U37890 | (02) | TX |