Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | J9135 | TX |
NPI | 1083721377 |
---|---|
Provider Name | Lee Kirchner |
First Address | San Antonio, TX 78231-1255 |
Second Address | San Antonio, TX 78231-1255 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 02/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
089937904 | (05) | TX |
G62777 | (02) |