Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 7906 | TX |
N | 111NN0400X | Neurology | 7906 | TX |
NPI | 1245235589 |
---|---|
Provider Name | Dr. Michael Combs |
First Address | Arlington, TX 76018-1030 |
Second Address | Arlington, TX 76018-1030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2005 |
Last Update Date | 01/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U72986 | (02) | TX |