Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | P6867 | TX |
NPI | 1992012470 |
---|---|
Provider Name | Dr. Jennifer Mccracken |
First Address | Galveston, TX 77555-0550 |
Second Address | Galveston, TX 77555-0550 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2010 |
Last Update Date | 06/11/2019 |