Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0116026789 | VA |
Y | 2080P0202X | Pediatric Cardiologist | DR.0066253 | CO |
NPI | 1245643121 |
---|---|
Provider Name | Dr. Hieu Ta |
First Address | Aurora, CO 80045-7106 |
Second Address | Aurora, CO 80045-7106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2014 |
Last Update Date | 09/09/2021 |