Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | M9913 | TX |
N | 2080P0207X | Pediatric Hematology-Oncologist | 060161 | GA |
Y | 2080P0207X | Pediatric Hematology-Oncologist | M9913 | TX |
N | 2080P0207X | Pediatric Hematology-Oncologist | MD 28334 | SC |
NPI | 1134237001 |
---|---|
Provider Name | Mary Ellen Cavalier |
First Address | Frisco, TX 75035-0226 |
Second Address | Frisco, TX 75034-7461 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 05/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
283348 | (05) | SC |
I43722 | (02) |