Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 34265 | TX |
N | 1223G0001X | General Practice | 62122 | CA |
N | 213EG0000X | General Practice | 62122 | CA |
NPI | 1275881575 |
---|---|
Provider Name | Dr. Roy Bolden Hooks JR. |
First Address | Tomball, TX 77375-4470 |
Second Address | Round Rock, TX 78681 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2012 |
Last Update Date | 30/06/2020 |