Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | H8081 | TX |
NPI | 1033101902 |
---|---|
Provider Name | Michael M Gnuechtel |
First Address | Kerrville, TX 78029-3355 |
Second Address | Kerrville, TX 78028-5822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2005 |
Last Update Date | 28/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
096908102 | (05) | TX |
742906311 | TAX ID (01) | TX |
G73285 | (02) | TX |