Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | H9421 | TX |
NPI | 1114920063 |
---|---|
Provider Name | Dr. L. Reed Shirley |
First Address | Houston, TX 77082-2790 |
Second Address | Sugar Land, TX 77478-3879 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 13/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102567802 | (05) | TX |
C68948 | (02) | TX |