Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | H9769 | TX |
NPI | 1043278187 |
---|---|
Provider Name | Dr. Molly May Bankhead |
First Address | Arp, TX 75750-9514 |
Second Address | Arp, TX 75750-9514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 18/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F56742 | (02) | TX |