Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | L9557 | TX |
NPI | 1023006491 |
---|---|
Provider Name | Dr. David W Wimberley |
First Address | Houston, TX 77030-4509 |
Second Address | Houston, TX 77030-4509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 19/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
166342901 | (05) | TX |
H62655 | (02) | TX |