Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 1422 | TX |
NPI | 1073564233 |
---|---|
Provider Name | Dr. John M Ehret |
First Address | Montgomery, TX 77356-5738 |
Second Address | Montgomery, TX 77356-5738 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 03/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018600902 | (05) | TX |
U72441 | (02) |