Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 1045 | TX |
NPI | 1619943321 |
---|---|
Provider Name | Dr. John Howard Ognibene |
First Address | El Paso, TX 79920-5001 |
Second Address | El Paso, TX 79920-5001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F000B43A9 | (05) | TX |
T-79062 | (02) | TX |