Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | L2412 | TX |
NPI | 1811991367 |
---|---|
Provider Name | Dr. Fernando Pano Levaro |
First Address | Houston, TX 77004-6944 |
Second Address | Houston, TX 77004-6944 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2005 |
Last Update Date | 28/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
151524902 | (05) | TX |
H57402 | (02) | TX |