Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | H5973 | TX |
NPI | 1457445082 |
---|---|
Provider Name | John M. Skibber |
First Address | Houston, TX 77210-4439 |
Second Address | Houston, TX 77030-4009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 05/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020021412 | RR MEDICARE (01) | TX |
36523101 | (05) | TX |
800478 | BCBS (01) | TX |
E09251 | (02) |