Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 290194 | MA |
N | 207T00000X | Neurosurgeon | MD459587 | PA |
N | 207T00000X | Neurosurgeon | S5244 | TX |
NPI | 1003251554 |
---|---|
Provider Name | Joel Zachary Passer |
First Address | Burlington, MA 01805-0001 |
Second Address | Houston, TX 77030-4000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2013 |
Last Update Date | 29/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
412619501 | (05) | TX |
412619502 | CSHCN TPI (01) | TX |