Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | BP10037620 | TX |
Y | 207Q00000X | Family Doctor | P7716 | TX |
NPI | 1003103128 |
---|---|
Provider Name | Dr. Dimple Butler |
First Address | Corpus Christi, TX 78414-4100 |
Second Address | Corpus Christi, TX 78414-4100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2011 |
Last Update Date | 16/12/2019 |