Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | L7779 | TX |
NPI | 1568561397 |
---|---|
Provider Name | Dr. Lynne Marie Knowles |
First Address | Dallas, TX 75391-1230 |
Second Address | Austin, TX 78731-4214 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 20/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
165298401 | (05) | TX |
165298402 | (05) | TX |
165298403 | (05) | TX |
8W1538 | BCBS (01) | TX |
H99187 | (02) | TX |