Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | E4306 | TX |
NPI | 1063415883 |
---|---|
Provider Name | Guy Kenneth Driggs |
First Address | Addison, TX 75001-0580 |
Second Address | Dallas, TX 75235-6413 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 17/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D48252 | (02) | TX |