Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | G6240 | TX |
NPI | 1124060256 |
---|---|
Provider Name | Dr. Laurence Kevin Tokaz |
First Address | Dallas, TX 75391-1230 |
Second Address | Austin, TX 78745-3325 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 13/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
134191901 | (05) | TX |
134191902 | (05) | TX |
134191908 | (05) | TX |
8R1569 | BLUE CROSS OF TEXAS (01) | TX |
C22705 | (02) |