Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | L1720 | TX |
Y | 208600000X | Surgeon | L1720 | TX |
NPI | 1003025628 |
---|---|
Provider Name | Dr. Diane C Robinson |
First Address | Texas City, TX 77591-2546 |
Second Address | Texas City, TX 77591-2546 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 14/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
144544701 | (05) | TX |
G28091 | (02) | TX |
P00644611 | (05) | TX |