Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | H7517 | TX |
NPI | 1164402301 |
---|---|
Provider Name | Kenneth J. Trimmer |
First Address | Plano, TX 75075-6138 |
Second Address | Plano, TX 75093-7939 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E35106 | (02) | TX |