Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 21720 | NE |
Y | 207VX0201X | Gynecologic Oncologist | J5990 | TX |
NPI | 1477518686 |
---|---|
Provider Name | Dr. Noelle Gillette Cloven |
First Address | Dallas, TX 75391-1230 |
Second Address | Fort Worth, TX 76104-2154 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 09/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10025044500 | (05) | NE |
202984501 | (05) | TX |
202984502 | (05) | TX |
G53073 | (02) | NE |
P00115387 | RAILROAD MEDICARE (01) | NE |
P00769778 | RAILROAD MEDICARE (01) | TX |