Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1471 | TX |
Y | 222Z00000X | Podiatrist | 1471 | TX |
NPI | 1023063195 |
---|---|
Provider Name | Frederick Elefano Quirante |
First Address | Nederland, TX 77627 |
Second Address | Nederland, TX 77627 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 07/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0044DZ | BCBS (01) | TX |
018601701 | (05) | TX |
U72460 | (02) |