Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 24599 | NC |
N | 2084N0402X | Child Neurologist | 24599 | NC |
NPI | 1144321373 |
---|---|
Provider Name | Dr. Henry Joseph Horacek JR. |
First Address | Charlotte, NC 28226-3783 |
Second Address | Charlotte, NC 28226-3783 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 08/07/2007 |