Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | N6238 | TX |
NPI | 1194934273 |
---|---|
Provider Name | Dr. Luminita S Crisan |
First Address | Arlington, TX 76014-2083 |
Second Address | Arlington, TX 76014-2083 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 15/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000381000 | (05) | FL |
68670 | BLUE CROSS BLUE SHIELD (01) | FL |