Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | E6333 | TX |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | E6333 | TX |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | E6333 | TX |
NPI | 1023000171 |
---|---|
Provider Name | Melinda A Duncan |
First Address | Palestine, TX 75801-4780 |
Second Address | Palestine, TX 75801-4780 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 27/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
016928354 | RR MEDICARE (01) | TX |
122764704 | (05) | TX |
B87582 | (02) | TX |