Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | N1941 | TX |
NPI | 1376723940 |
---|---|
Provider Name | Joseph C Vineyard |
First Address | Dallas, TX 75231-0806 |
Second Address | Dallas, TX 75231-0806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2007 |
Last Update Date | 04/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
297161601 | (05) | TX |