Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0106X | Oral and Maxillofacial Pathology | 22969 | TX |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 5529 | LA |
NPI | 1497788368 |
---|---|
Provider Name | Dr. Jeffrey Walker Dongieux |
First Address | Kenner, LA 70065 |
Second Address | Houston, TX 77055-2023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 12/09/2013 |