Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | K0704 | TX |
NPI | 1447232467 |
---|---|
Provider Name | Dr. John L. Dalrymple |
First Address | Austin, TX 78701-1943 |
Second Address | Austin, TX 78705-1188 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2005 |
Last Update Date | 18/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
041389005 | (05) | TX |