Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | E6739 | TX |
NPI | 1184651895 |
---|---|
Provider Name | Ian J Butler |
First Address | Houston, TX 77216-1088 |
Second Address | Houston, TX 77030-3000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 05/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
139295306 | (05) | TX |
139295308 | CSHCN (01) | TX |
139295316 | (05) | TX |
139295317 | CSHCN (01) | TX |
87X553 | BCBS (01) | TX |
8U4869 | BCBSTX (01) | TX |
C14009 | (02) |