Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 0584 | TX |
Y | 222Z00000X | Podiatrist | 0584 | TX |
NPI | 1043206121 |
---|---|
Provider Name | Dr. Edward T. Mccaffrey |
First Address | Temple, TX 76502-1814 |
Second Address | Temple, TX 76502-1838 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 01/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
121556801 | (05) | TX |
T14670 | (02) |