Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | L0558 | TX |
NPI | 1023093291 |
---|---|
Provider Name | Dr. Eric Sabonghy |
First Address | Houston, TX 77030-1526 |
Second Address | Houston, TX 77024-1287 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2005 |
Last Update Date | 11/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
613174800 | DEPARTMENT OF LABOR (01) | TX |
7857805 | AETNA (01) | TX |
8AA920 | BLUE CROSS AND BLUE SHIELD OF TEXAS (01) | TX |