Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1546 | TX |
Y | 222Z00000X | Podiatrist | 1546 | TX |
N | 224P00000X | Prosthetist | 1546 | TX |
NPI | 1083972962 |
---|---|
Provider Name | Jim P Brookshier |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2012 |
Last Update Date | 31/07/2018 |