Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | BP10056881 | TX |
NPI | 1003263468 |
---|---|
Provider Name | Dr. Miguel A Nieto |
First Address | Houston, TX 77030 |
Second Address | Houston, TX 77030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2016 |
Last Update Date | 16/05/2016 |