Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 2019009746 | MO |
N | 208200000X | Surgeon | 2019009746 | MO |
N | 208600000X | Surgeon | 2019009746 | MO |
NPI | 1043576101 |
---|---|
Provider Name | Dr. Teresa Catherine Rice |
First Address | Saint Louis, MO 63110-1010 |
Second Address | Saint Louis, MO 63110-1032 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2012 |
Last Update Date | 12/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200072153 | (05) | MO |