Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0101235593 | VA |
N | 208000000X | Pediatrician | N4032 | TX |
Y | 2080P0203X | Pediatric Critical Care Doctor | N4032 | TX |
NPI | 1154425593 |
---|---|
Provider Name | Dr. Monica Relvas |
First Address | Lubbock, TX 79410-1314 |
Second Address | Lubbock, TX 79410-1226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 11/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C09463 | GROUP PTAN (01) | VA |
H70942 | (02) |