Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 222713-1 | NY |
N | 207P00000X | Emergency Physician | 34007799 | OH |
Y | 207P00000X | Emergency Physician | K7761 | TX |
NPI | 1003913880 |
---|---|
Provider Name | John Herrick |
First Address | Dallas, TX 75284-0001 |
Second Address | Corpus Christi, TX 78405-1804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 19/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
148591402 | (05) | TX |
H54313 | (02) |