Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | PA11817 | TX |
NPI | 1184126575 |
---|---|
Provider Name | Edward Y Ji |
First Address | Houston, TX 77098-1352 |
Second Address | Baytown, TX 77521-3947 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2018 |
Last Update Date | 01/03/2018 |