Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN0400X | Neurology | 9958 | TX |
N | 111NR0200X | Radiology | 9958 | TX |
N | 213ER0200X | Radiology | 9958 | TX |
N | 111NR0400X | Rehabilitation Chiropractor | 9958 | TX |
N | 111NS0005X | Chiropractic Sports Physician | 9958 | TX |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 9958 | TX |
NPI | 1639219785 |
---|---|
Provider Name | Dr. Kenneth D Efird |
First Address | Houston, TX 77027-7339 |
Second Address | Houston, TX 77027-7339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AG7016 | ROPM-BCBS OON PROVIDER # (01) | TX |
V06889 | (02) | TX |