Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | R9035 | TX |
N | 207ND0900X | Dermatopathologist | R9035 | TX |
NPI | 1760860381 |
---|---|
Provider Name | Emily Li Sou |
First Address | Pearland, TX 77584-7298 |
Second Address | Houston, TX 77057-2209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2015 |
Last Update Date | 21/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
397841302 | (05) | TX |
397841303 | (05) | TX |
397841304 | (05) | TX |