Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 12456 | TX |
NPI | 1013098086 |
---|---|
Provider Name | Helen Lee Joiner |
First Address | College Station, TX 77840-4494 |
Second Address | College Station, TX 77840-4494 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 08/07/2007 |