Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MD.203444 | LA |
NPI | 1023347358 |
---|---|
Provider Name | Dr. Faith Data Atai |
First Address | Missouri City, TX 77459-7104 |
Second Address | Missouri City, TX 77459-7104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2009 |
Last Update Date | 13/10/2010 |