Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 19127 | TX |
NPI | 1699701938 |
---|---|
Provider Name | Dr. Harold Clark Whitmire JR. |
First Address | Kingwood, TX 77345-1744 |
Second Address | Kingwood, TX 77345-1744 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2006 |
Last Update Date | 31/05/2013 |