Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | J8335 | TX |
NPI | 1194805507 |
---|---|
Provider Name | Jed G. Nuchtern |
First Address | Houston, TX 77046-0297 |
Second Address | Houston, TX 77030-2316 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 01/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
138687202 | CSHCN (01) | TX |
138687203 | (05) | TX |
138687214 | (05) | TX |
138687215 | CSHCN (01) | TX |
F33256 | (02) |