Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 44832 | TX |
NPI | 1053708503 |
---|---|
Provider Name | Marc Anders |
First Address | Houston, TX 77030-2358 |
Second Address | Houston, TX 77030-2358 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2015 |
Last Update Date | 06/05/2015 |