Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | E0226 | TX |
NPI | 1306827423 |
---|---|
Provider Name | Marcos Calderon |
First Address | Houston, TX 77210-4346 |
Second Address | Houston, TX 77047-1923 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C14072 | (02) |