Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | N6379 | TX |
NPI | 1013116805 |
---|---|
Provider Name | Dr. Tim T Issac |
First Address | Dallas, TX 75231-4388 |
Second Address | Duncanville, TX 75116-4914 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2007 |
Last Update Date | 13/12/2016 |