Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 01060354A | IN |
N | 2080N0001X | Neonatal-Perinatal Doctor | 15807 | HI |
Y | 2080N0001X | Neonatal-Perinatal Doctor | P6473 | TX |
NPI | 1013981190 |
---|---|
Provider Name | Dr. Thornton Samuel Mu |
First Address | Jbsa Ft Sam Houston, TX 78234-4504 |
Second Address | Fort Sam Houston, TX 78234-4504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 10/12/2020 |