Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | S1657 | TX |
NPI | 1205254943 |
---|---|
Provider Name | Kayla Mcniece |
First Address | Bellaire, TX 77401-3505 |
Second Address | Bellaire, TX 77401-3505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2014 |
Last Update Date | 27/04/2021 |