Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | J4505 | TX |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | MD60910980 | WA |
N | 207RC0000X | Internist - Cardiovascular Disease | J4505 | TX |
NPI | 1801919147 |
---|---|
Provider Name | Dr. Robert C Scott III |
First Address | Dallas, TX 75284-4658 |
Second Address | Spokane, WA 99204-2354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 31/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BS4048612 | DEA (01) | |
G71609 | (02) | TX |