Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | H7738 | TX |
NPI | 1083656078 |
---|---|
Provider Name | Dr. Timothy Kilian George |
First Address | Dallas, TX 75391-1230 |
Second Address | Odessa, TX 79761-5413 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 15/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00033431 | (05) | NM |
136959701 | (05) | TX |
136959703 | (05) | TX |
136959704 | (05) | TX |
136959708 | CSHCN (01) | TX |
136959711 | (05) | TX |
8R1595 | BLUE CROSS OF TEXAS (01) | TX |
900003012 | RR MEDICARE (01) | TX |
D35650 | (02) | TX |