Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | P3621 | TX |
NPI | 1447489364 |
---|---|
Provider Name | Kenneth Andrew Estrera |
First Address | Arlington, TX 76015-3604 |
Second Address | Dallas, TX 75235-7708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2009 |
Last Update Date | 22/12/2017 |