Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | P5102 | TX |
Y | 207XS0117X | Orthopaedic Spine Surgeon | P5102 | TX |
NPI | 1275791303 |
---|---|
Provider Name | Hongbo Liu |
First Address | San Antonio, TX 78258-3281 |
Second Address | San Antonio, TX 78258-3281 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2008 |
Last Update Date | 08/07/2015 |