Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | N2102 | TX |
NPI | 1225279409 |
---|---|
Provider Name | Dr. Michael Edward Haas |
First Address | Schertz, TX 78154-1277 |
Second Address | Schertz, TX 78154-1277 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2009 |
Last Update Date | 06/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
N2102 | MEDICAL TEXAS LICENSE (01) | TX |