Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 99238 | TX |
NPI | 1063893311 |
---|---|
Provider Name | Elizabeth Spring |
First Address | Dallas, TX 75211-4961 |
Second Address | Dallas, TX 75211-4961 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2015 |
Last Update Date | 12/06/2015 |