Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | M3714 | TX |
NPI | 1285602300 |
---|---|
Provider Name | Dr. Wagdy S Rizk |
First Address | Beaumont, TX 77707-2216 |
Second Address | Beaumont, TX 77707-2216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 10/07/2007 |