Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 13415 | TX |
Y | 111NP0017X | Pediatric Chiropractor | 13415 | TX |
NPI | 1508352162 |
---|---|
Provider Name | Dr. Janair Osarollor |
First Address | Desoto, TX 75115-6687 |
Second Address | Desoto, TX 75115-6420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2018 |
Last Update Date | 28/09/2019 |