Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | Q3015 | TX |
NPI | 1023278660 |
---|---|
Provider Name | Leslie M. Hutchins |
First Address | Abilene, TX 79601-2452 |
Second Address | San Angelo, TX 76903-5400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2008 |
Last Update Date | 16/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8EZ046 | BCBS (01) | TX |