Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | J4272 | TX |
N | 111NI0900X | Internist | J4272 | TX |
Y | 208000000X | Pediatrician | J4272 | TX |
NPI | 1013080761 |
---|---|
Provider Name | John D Knight |
First Address | Huntsville, TX 77340-0010 |
Second Address | Huntsville, TX 77340-4945 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 22/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
89W423 | (02) | |
G45014 | (02) | TX |