Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 19290 | TX |
NPI | 1053416610 |
---|---|
Provider Name | Dr. James Darrell Steele |
First Address | Coppell, TX 75019-2142 |
Second Address | Coppell, TX 75019-2142 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G65909 | (02) | TX |