Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 31872 | KY |
N | 208600000X | Surgeon | 31872 | KY |
Y | 2086S0122X | Plastic and Reconstructive Surgery | M8505 | TX |
NPI | 1235119322 |
---|---|
Provider Name | Gary I. Arishita |
First Address | San Antonio, TX 78229 |
Second Address | San Antonio, TX 78240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2006 |
Last Update Date | 15/09/2008 |