Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | N9348 | TX |
NPI | 1003069758 |
---|---|
Provider Name | Dr. Tanner B Baker |
First Address | Friendswood, TX 77546-3801 |
Second Address | Houston, TX 77063-2032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2008 |
Last Update Date | 27/09/2012 |