Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 1-29378 | ZZ |
N | 111NI0900X | Internist | 1-29378 | ZZ |
N | 207RH0000X | Hematologist | 1-2717 | ZZ |
Y | 207RH0003X | Hematology & Oncology | BP10058924 | TX |
NPI | 1164957437 |
---|---|
Provider Name | Dr. Eran Tallis |
First Address | Houston, TX 77096-1103 |
Second Address | Houston, TX 77030-4000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2017 |
Last Update Date | 25/04/2017 |