Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | L7191 | TX |
Y | 208000000X | Pediatrician | L7191 | TX |
NPI | 1285728055 |
---|---|
Provider Name | Frank J Sloan |
First Address | Fort Worth, TX 76199-0213 |
Second Address | Fort Worth, TX 76104-2717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 20/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H91774 | (02) |