Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 10696 | TX |
NPI | 1053328740 |
---|---|
Provider Name | Dr. Richard Stark Finlayson |
First Address | San Antonio, TX 78249-4133 |
Second Address | San Antonio, TX 78232-1246 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 08/07/2007 |