Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | T0135 | TX |
N | 207RI0011X | Interventional Cardiology | T0135 | TX |
NPI | 1114313095 |
---|---|
Provider Name | Lily Bates |
First Address | San Antonio, TX 78213-3329 |
Second Address | San Antonio, TX 78258-4298 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2015 |
Last Update Date | 25/08/2021 |