Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | G9537 | TX |
NPI | 1013901826 |
---|---|
Provider Name | Julie D Sorenson |
First Address | Harlingen, TX 78550-8736 |
Second Address | Harlingen, TX 78550-8736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2005 |
Last Update Date | 19/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
137531314 | (05) | TX |
C22079 | (02) |