Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | D4070 | TX |
N | 207RX0202X | Medical Oncology | D4070 | TX |
NPI | 1124060546 |
---|---|
Provider Name | Dr. Philip Cimo |
First Address | Dallas, TX 75391-1230 |
Second Address | Houston, TX 77024-2545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2006 |
Last Update Date | 25/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
119040701 | (05) | TX |
119040702 | (05) | TX |
119040704 | (05) | TX |
119040705 | (05) | TX |
830002244 | RAILROAD (01) | |
8R1411 | BLUE CROSS OF TEXAS (01) | TX |
C14494 | (02) |