Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | E4401 | TX |
NPI | 1003856337 |
---|---|
Provider Name | George Louis Herlin |
First Address | Dallas, TX 75265-0865 |
Second Address | Houston, TX 77042-2300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 27/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
152092603 | (05) | TX |
152092604 | (05) | TX |
8DW153 | BCBS (01) | TX |