Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | H5312 | TX |
NPI | 1013099399 |
---|---|
Provider Name | Mavis D Fujii |
First Address | Houston, TX 77058-3860 |
Second Address | Houston, TX 77058-3860 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G67039 | (02) | TX |