Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 57.025955 | OH |
Y | 207YS0123X | Facial Plastic Surgeon | S4875 | TX |
NPI | 1962896977 |
---|---|
Provider Name | Jeanie Sozansky Lujan |
First Address | San Antonio, TX 78230-5469 |
Second Address | San Antonio, TX 78230-5469 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2015 |
Last Update Date | 20/09/2020 |