Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 22845 | TX |
Y | 213EG0000X | General Practice | 22845 | TX |
N | 1223P0300X | Periodontist | 22845 | TX |
NPI | 1003034372 |
---|---|
Provider Name | Jessica Maria Baez |
First Address | The Woodlands, TX 77380-1968 |
Second Address | Spring, TX 77380-3552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 16/05/2008 |