Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | G3303 | TX |
NPI | 1568429975 |
---|---|
Provider Name | Kevin John Doody |
First Address | Bedford, TX 76022-6033 |
Second Address | Bedford, TX 76022-6033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D95151 | (02) |