Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0122X | Plastic and Reconstructive Surgery | S0034499 | FL |
Y | 2086S0122X | Plastic and Reconstructive Surgery | S0034499 | TX |
NPI | 1235203993 |
---|---|
Provider Name | Dr. James M Landeen |
First Address | San Antonio, TX 78229 |
Second Address | San Antonio, TX 78229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C18122 | (02) |