Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | G3946 | TX |
NPI | 1669480919 |
---|---|
Provider Name | Dr. Jacobo Varon |
First Address | Houston, TX 77001-0048 |
Second Address | Houston, TX 77054-1920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D69218 | (02) | TX |
G3946 | TX MEDICAL LICENSE ID (01) | TX |
MDG3946TX | WORKERS COMPENSATION (01) | TX |