Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | L6131 | TX |
NPI | 1326058835 |
---|---|
Provider Name | John Mckay Noack |
First Address | Dallas, TX 75231-3833 |
Second Address | Dallas, TX 75231-3833 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 23/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
168412801 | (05) | TX |
I16520 | (02) | TX |