Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 630820 | TX |
NPI | 1043496110 |
---|---|
Provider Name | Elisha Mccall-Preston |
First Address | Paris, TX 75460-8076 |
Second Address | Paris, TX 75460-8076 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2008 |
Last Update Date | 23/02/2011 |