Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 488 | TX |
NPI | 1285622563 |
---|---|
Provider Name | Dr. Harry Yankuner |
First Address | Dallas, TX 75230-6101 |
Second Address | Dallas, TX 75230-2712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 10/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T16767 | (02) | TX |