Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | K0522 | TX |
N | 207QA0505X | Family Doctor - Adult Medicine | K0522 | TX |
NPI | 1225057854 |
---|---|
Provider Name | Dr. Nicole Mcginty |
First Address | Houston, TX 77098-1971 |
Second Address | Houston, TX 77098-1971 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 02/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0312803-01T | (05) | TX |
G78043 | (02) | TX |