Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | R5488 | TX |
NPI | 1013138593 |
---|---|
Provider Name | Jeff Waugh |
First Address | Dallas, TX 75235-7701 |
Second Address | Dallas, TX 75235-8075 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 22/05/2019 |