Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | H2281 | TX |
NPI | 1003846288 |
---|---|
Provider Name | Dr. Stanley Cal |
First Address | Fort Worth, TX 76104-4917 |
Second Address | Fort Worth, TX 76104-4917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
124173905 | (05) | TX |
E04482 | (02) | TX |