Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | N0769 | TX |
NPI | 1023165917 |
---|---|
Provider Name | Dr. John Robert Floyd II |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78229-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 28/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200100001 | (05) | TX |
200100002 | CSN (01) | TX |
8AL631 | BLUE CROSS BLUE SHIELD (01) | TX |