Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | F2090 | TX |
NPI | 1245395755 |
---|---|
Provider Name | Dr. Michael Lee Walker |
First Address | Fredericksburg, TX 78624-4408 |
Second Address | Fredericksburg, TX 78624-4408 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2006 |
Last Update Date | 26/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F37158 | (02) | TX |