Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 41863 | AZ |
N | 204F00000X | Transplant Surgeon | 44553 | MN |
N | 208200000X | Surgeon | 41863 | AZ |
N | 208600000X | Surgeon | 41863 | AZ |
NPI | 1730308123 |
---|---|
Provider Name | Dr. Tun Jie |
First Address | Dallas, TX 75284-4658 |
Second Address | Temple, TX 76508-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 17/09/2020 |