Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | G5703 | TX |
NPI | 1003814211 |
---|---|
Provider Name | Dr. Larry Jay Tremper |
First Address | El Paso, TX 79902-4672 |
Second Address | El Paso, TX 79902-4672 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 03/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110680902 | (05) | TX |
G46174 | (02) | TX |