Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | TX0516 | TX |
Y | 222Z00000X | Podiatrist | TX0516 | TX |
NPI | 1053365775 |
---|---|
Provider Name | Dr. Fred Arnold Sternberg |
First Address | Grand Prairie, TX 75051-3767 |
Second Address | Grand Prairie, TX 75051-3767 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T16113 | (02) | TX |