Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | M2732 | TX |
N | 207XS0106X | Orthopaedic Hand Surgeon | M2732 | TX |
Y | 2086S0105X | Surgery of the Hand | M2732 | TX |
NPI | 1225028491 |
---|---|
Provider Name | Dr. Jose Miguel Nolla |
First Address | Pearland, TX 77584-7298 |
Second Address | Houston, TX 77025-1669 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2005 |
Last Update Date | 28/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
181515101 | (05) | TX |
8P5576 | BCBS TEXAS (01) | TX |