Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | F4024 | TX |
N | 2080P0208X | Pediatric Infectious Diseases | F4024 | TX |
NPI | 1215980032 |
---|---|
Provider Name | Dr. Marilyn Mae Doyle |
First Address | Galveston, TX 77555-5302 |
Second Address | Austin, TX 78701-1954 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 19/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C16322 | (02) |