Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | L4738 | TX |
N | 111NI0900X | Internist | L4738 | TX |
N | 207RG0300X | Geriatric Medicine | 2020-03905 | NC |
Y | 207RG0300X | Geriatric Medicine | L4738 | TX |
NPI | 1023049053 |
---|---|
Provider Name | Jill Louise Studley |
First Address | Baltimore, MD 21228-4873 |
Second Address | Dallas, TX 75252-6834 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 14/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1515496-02 | (05) | TX |
1515496-03 | (05) | TX |
8S3697 | BCBS (01) | TX |
8X0054 | BCBS (01) | TX |
H62350 | (02) | TX |