Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 18851 | TX |
NPI | 1245398973 |
---|---|
Provider Name | Dr. Louis Philippe Bosse |
First Address | Houston, TX 77060 |
Second Address | Houston, TX 77060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 03/10/2007 |