Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 42671 | TX |
N | 208600000X | Surgeon | 42671 | TX |
Y | 208200000X | Surgeon | N6387 | TX |
Y | 208600000X | Surgeon | N6387 | TX |
N | 2086X0206X | Surgical Oncologist | 036-074551 | IL |
NPI | 1083779532 |
---|---|
Provider Name | Dr. Ismail Jatoi |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78229-4427 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2006 |
Last Update Date | 29/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
209871701 | (05) | TX |
209871702 | CSHCN (01) | TX |