Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 17294 | TX |
NPI | 1043437023 |
---|---|
Provider Name | Dr. Sharon Minott-Warren |
First Address | Pearland, TX 77584 |
Second Address | Pearland, TX 77584-7879 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2007 |
Last Update Date | 08/07/2007 |