Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | M7198 | TX |
NPI | 1154360923 |
---|---|
Provider Name | Dr. Vincent C. Freemyer |
First Address | Temple, TX 76508-0001 |
Second Address | San Antonio, TX 78205-1201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 07/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
187321801 | (05) | TX |
8AN320 | BCBSTX (01) | TX |