Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | K6004 | TX |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | K6004 | TX |
NPI | 1689733107 |
---|---|
Provider Name | Dr. William Barry Humeniuk |
First Address | Mckinney, TX 75070-2188 |
Second Address | Mckinney, TX 75070-2188 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 07/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0027DW | BLUE CROSS BLUE SHIELD (01) | TX |
H03311 | (02) |