Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | F4569 | TX |
NPI | 1003824509 |
---|---|
Provider Name | George Nicholas Stokes |
First Address | Cleveland, TX 77327-4063 |
Second Address | Cleveland, TX 77327 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 16/04/2012 |