Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | P6878 | TX |
NPI | 1104143916 |
---|---|
Provider Name | Gregory Lane Naugher |
First Address | San Antonio, TX 78216-6905 |
Second Address | San Antonio, TX 78216-6905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2010 |
Last Update Date | 21/07/2017 |