Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | H0095 | TX |
NPI | 1023076205 |
---|---|
Provider Name | John M Passmore JR. |
First Address | Houston, TX 77074-1802 |
Second Address | Houston, TX 77074-1802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 22/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
045640202 | (05) | TX |
045640203 | (05) | TX |
045640204 | (05) | TX |
045640205 | (05) | TX |
1023076205 | BLUE CROSS BLUE SHIELD (01) | TX |
C20250 | (02) | |
P01089601 | RR MEDICARE (01) | TX |