Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | G7533 | TX |
NPI | 1114927779 |
---|---|
Provider Name | Emily M. Isaacs |
First Address | Fort Worth, TX 76109-3562 |
Second Address | Fort Worth, TX 76109-3562 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 28/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
098595401 | (05) | TX |
098595403 | (05) | TX |
098595404 | (05) | TX |
C17317 | (02) |