Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 11723 | TX |
NPI | 1235178864 |
---|---|
Provider Name | Dr. James Clay Lemon |
First Address | Slaton, TX 79364-7912 |
Second Address | Lubbock, TX 79410-1837 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 28/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T14379 | (02) | TX |