Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | L8794 | TX |
NPI | 1073662268 |
---|---|
Provider Name | Jodi Gould Lemeshev |
First Address | Mesquite, TX 75149-7414 |
Second Address | Mesquite, TX 75149-7414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 08/07/2007 |