Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME89773 | FL |
N | 111NI0900X | Internist | ME89773 | FL |
Y | 207RH0003X | Hematology & Oncology | N3085 | TX |
N | 207RX0202X | Medical Oncology | N3085 | TX |
NPI | 1154346963 |
---|---|
Provider Name | Jade Homsi |
First Address | Dallas, TX 75284-7208 |
Second Address | Dallas, TX 75235-7320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 22/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
274979300 | (05) | FL |
41748 | BLUE CROSS BLUE SHIELD (01) | FL |
I52044 | (02) | FL |