Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | D4692 | TX |
Y | 208D00000X | General Practice Physician | D69208 | TX |
NPI | 1093743403 |
---|---|
Provider Name | Dr. Roy Wayne Turner |
First Address | Hurst, TX 76054-2707 |
Second Address | Hurst, TX 76054-2707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 03/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D69208 | (02) | TX |