Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | H8277 | TX |
NPI | 1043380496 |
---|---|
Provider Name | Dr. Patric Yves Nassaux |
First Address | Albuquerque, NM 87111-3790 |
Second Address | Kirtland Afb, NM 87111-5522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H8277 | LICENSE (01) | TX |