Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 0101055059 | VA |
NPI | 1184657454 |
---|---|
Provider Name | Dr. Latha Navara |
First Address | Fort Worth, TX 76119-5863 |
Second Address | Fort Worth, TX 76119-5863 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 08/07/2012 |