Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC1900X | Counseling Psychologist | ||
N | 2084N0400X | Neurologist | K9823 | TX |
Y | 2084N0402X | Child Neurologist | K9823 | TX |
N | 2084N0600X | Clinical Neurophysiologist | K9823 | TX |
NPI | 1689757189 |
---|---|
Provider Name | Dr. Nathaniel Acebedo Kho |
First Address | Plano, TX 75094-1408 |
Second Address | Dallas, TX 75234-7852 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 31/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0007465251 | AETNA PROVIDER NUMBER (01) | TX |
16MN | BCBS GROUP NUMBER (01) | TX |
4242217 | BLUELINK ID (01) | TX |
8298271 | CIGNA PROVIDER NUMBER (01) | TX |
8R9390 | BCBS PROVIDER NUMBER (01) | TX |