Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | J3461 | TX |
NPI | 1578542387 |
---|---|
Provider Name | Dr. Stuart William Ehrett |
First Address | Carrollton, TX 75007-1645 |
Second Address | Carrollton, TX 75007-1645 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2006 |
Last Update Date | 02/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100184470A | (05) | OK |
134750204 | (05) | TX |
89310K | BCBS (01) | TX |
F59992 | (02) |