Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | M7103 | TX |
NPI | 1053394197 |
---|---|
Provider Name | Dr. Moncenya Ladonna Chatman |
First Address | Kingwood, TX 77339-6406 |
Second Address | Kingwood, TX 77339-6405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2005 |
Last Update Date | 14/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
189894209 | (05) | TX |
I09798 | (02) |