Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | F3226 | TX |
NPI | 1144249921 |
---|---|
Provider Name | Dr. Lillian M Jones |
First Address | San Antonio, TX 78229-3786 |
Second Address | San Antonio, TX 78229-3786 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 27/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
113433002 | (05) | TX |
742529053 | TAX ID (01) | TX |
E81021 | (02) | TX |