Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 4491 | TX |
NPI | 1801853619 |
---|---|
Provider Name | Dr. Ralph Theodore Muilenburg |
First Address | Houston, TX 77065-4239 |
Second Address | Houston, TX 77065-4239 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 08/07/2007 |