Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 036116403 | IL |
Y | 207T00000X | Neurosurgeon | N2478 | TX |
NPI | 1003038043 |
---|---|
Provider Name | Dr. Edward A M Duckworth |
First Address | Houston, TX 77030-2400 |
Second Address | Houston, TX 77030-2400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 29/07/2009 |