Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | BP1-0022040 | TX |
Y | 207L00000X | Anesthesiologist | N2467 | TX |
NPI | 1003010661 |
---|---|
Provider Name | Dr. Nicholas James Defilippis |
First Address | Houston, TX 77057-4817 |
Second Address | Houston, TX 77057-4817 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2007 |
Last Update Date | 30/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
206945202 | (05) | TX |
2795251762 | MYUTMB 2795251762-COMMERCIAL NUMBER (01) | |
8CL018 | BLUE CROSS BLUE SHIELD (01) | TX |