Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 000829-P.A. | PR |
NPI | 1083383186 |
---|---|
Provider Name | Javier German Padilla |
First Address | Laredo, TX 78043-4266 |
Second Address | Laredo, TX 78043-4266 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2021 |
Last Update Date | 10/09/2021 |