Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | MD 60221950 | WA |
Y | 2086S0120X | Pediatric Surgery | P5988 | TX |
NPI | 1407010069 |
---|---|
Provider Name | Matthew Harting |
First Address | Houston, TX 77030-1501 |
Second Address | Houston, TX 77030-3000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2008 |
Last Update Date | 07/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
322059201 | (05) | TX |
8DV043 | BCBS (01) | TX |