Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | D9036 | TX |
N | 207RH0003X | Hematology & Oncology | D9036 | TX |
NPI | 1417921032 |
---|---|
Provider Name | Dr. Ethan Allen Natelson |
First Address | Houston, TX 77074-4015 |
Second Address | Houston, TX 77030-2717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 03/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
041934303 | (05) | TX |
041934304 | (05) | TX |
8V4457 | BLUE CROSS BLUE SHIELD (01) | TX |
B25091 | (02) | TX |
DE4842 | RAILROAD MEDICARE (01) | TX |
P01265010 | RR MEDICARE (01) | TX |