Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | G6833 | TX |
NPI | 1093775611 |
---|---|
Provider Name | Dr. Jay S Gartner |
First Address | Duncanville, TX 75116 |
Second Address | Duncanville, TX 75116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 26/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C15975 | (02) | TX |