Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | F7464 | TX |
NPI | 1134118086 |
---|---|
Provider Name | Dr. Rowena B Garay |
First Address | Winnsboro, TX 75494-3060 |
Second Address | Winnsboro, TX 75494-3060 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2005 |
Last Update Date | 03/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
112074301 | (05) | TX |
112074303 | (05) | TX |
370000523 | MEDICARE RAILROAD (01) | TX |
C15876 | (02) | TX |