Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 1103 | TX |
NPI | 1003866179 |
---|---|
Provider Name | Dr. Scott W Mckinney |
First Address | Pasadena, TX 77505-3137 |
Second Address | Pasadena, TX 77505-3137 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 10/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
121564203 | (05) | TX |
U13666 | (02) | TX |