Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 58001946 | OH |
Y | 207P00000X | Emergency Physician | N3299 | TX |
NPI | 1003020785 |
---|---|
Provider Name | Dr. Jeff Sensenig |
First Address | San Antonio, TX 78229-5907 |
Second Address | San Antonio, TX 78229-5907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 24/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8CB026 | BCBSTX PROVIDER # (01) | TX |
TPI 203242701 | (05) | TX |