Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 228858 | TX |
NPI | 1013220698 |
---|---|
Provider Name | Mary A Best |
First Address | Galveston, TX 77555-5302 |
Second Address | Galveston, TX 77555-5302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2010 |
Last Update Date | 23/07/2010 |