Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YS0123X | Facial Plastic Surgeon | G7634 | TX |
Y | 208200000X | Surgeon | G7634 | TX |
Y | 208600000X | Surgeon | G7634 | TX |
N | 2082S0105X | Plastic Hand Surgeon | G7634 | TX |
NPI | 1093821274 |
---|---|
Provider Name | Joseph M Damiani |
First Address | Midland, TX 79701-5807 |
Second Address | Midland, TX 79701-5807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 06/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
033555602 | (05) | TX |
B52209 | (02) | TX |