Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | H3595 | TX |
N | 207VG0400X | Gynecologist | H3595 | TX |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | H3595 | TX |
N | 207VX0000X | Obstetrician | H3595 | TX |
NPI | 1275539025 |
---|---|
Provider Name | Julie Pao |
First Address | Dallas, TX 75266-0046 |
Second Address | Dallas, TX 75251-2126 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 29/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
943418344 | TAX ID (01) | TX |
E12517 | (02) |