Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1423 | TX |
Y | 222Z00000X | Podiatrist | 1423 | TX |
N | 224P00000X | Prosthetist | 1397 | TX |
NPI | 1255699252 |
---|---|
Provider Name | Jeremy Bilow |
First Address | Houston, TX 77025-5600 |
Second Address | Houston, TX 77025-5600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2012 |
Last Update Date | 26/04/2012 |