Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 9591 | TX |
NPI | 1003954975 |
---|---|
Provider Name | Dr. Reynaldo R. Amador |
First Address | Pasadena, TX 77502-3306 |
Second Address | Pasadena, TX 77502-3306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 24/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U99417 | (02) | TX |