Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | D0393 | TX |
NPI | 1013981240 |
---|---|
Provider Name | John Hyland |
First Address | Dallas, TX 75266-0080 |
Second Address | Dallas, TX 75226-1339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 19/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
134605811 | (05) | TX |
145164301 | (05) | TX |
145164302 | (05) | TX |