Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | J2803 | TX |
NPI | 1326005117 |
---|---|
Provider Name | Dr. John Anthony Sklar |
First Address | Fort Worth, TX 76102-5848 |
Second Address | Fort Worth, TX 76102-5848 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 25/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E39819 | (02) | TX |