Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 14758 | NH |
Y | 204F00000X | Transplant Surgeon | Q7371 | TX |
N | 208200000X | Surgeon | 14758 | NH |
N | 208600000X | Surgeon | 14758 | NH |
NPI | 1437232899 |
---|---|
Provider Name | Dr. Richard B . Freeman JR. |
First Address | Austin, TX 78712-1845 |
Second Address | Austin, TX 78712-1845 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2006 |
Last Update Date | 27/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1004372 | (05) | VT |
30008139 | (05) | NH |
B74912 | (02) |