Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | MD60839514 | WA |
NPI | 1598103970 |
---|---|
Provider Name | Dr. Jeffrey Cabral Teixeira |
First Address | Seattle, WA 98145-5095 |
Second Address | Tacoma, WA 98431-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2013 |
Last Update Date | 27/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1598103970 | (05) | WA |