Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | DR.0060388 | CO |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | R8653 | TX |
NPI | 1154686038 |
---|---|
Provider Name | Dr. Zayde Radwan |
First Address | Pearland, TX 77584-3773 |
Second Address | Pearland, TX 77584-3773 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2012 |
Last Update Date | 23/09/2019 |