Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207NS0135X | Procedural Dermatology | J3784 | TX |
NPI | 1336453190 |
---|---|
Provider Name | Dr. Kathryn Lorraine Duplantis |
First Address | Dallas, TX 75230-1400 |
Second Address | Dallas, TX 75230-1400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2010 |
Last Update Date | 03/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E67606 | (02) | TX |