Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | TEMP MED LICENSE | TX |
N | 208D00000X | General Practice Physician | N4260 | TX |
NPI | 1306172945 |
---|---|
Provider Name | Dr. Omar Steven Arrieta |
First Address | Georgetown, TX 78626-5826 |
Second Address | Temple, TX 76508-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2009 |
Last Update Date | 17/09/2021 |