Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 49941 | MN |
Y | 207RC0200X | Critical Care Medicine | P3296 | TX |
NPI | 1073710984 |
---|---|
Provider Name | Javier A Cabello Garza |
First Address | Harlingen, TX 78550 |
Second Address | Harlingen, TX 78550 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 20/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
311448001 | (05) | TX |
342600888 | MEDICARE PTAN (01) | TX |
557622100 | (05) | MN |