Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | T2156 | TX |
N | 207T00000X | Neurosurgeon | UO5370 | FL |
NPI | 1083141899 |
---|---|
Provider Name | James Ebot |
First Address | Plano, TX 75024-7311 |
Second Address | Frisco, TX 75033-4348 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2017 |
Last Update Date | 15/09/2021 |