Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | H9858 | TX |
Y | 207ND0900X | Dermatopathologist | H9858 | TX |
NPI | 1033214689 |
---|---|
Provider Name | Maria Isabel Colome |
First Address | Brentwood, TN 37027-7542 |
Second Address | Nashville, TN 37211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 08/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
124711609 | CSHCN (01) | TX |
124711614 | (05) | TX |
124711615 | (05) | TX |
124711616 | (05) | TX |
8B8801 | BCBSTX (01) | TX |