Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | K1059 | TX |
N | 207RA0401X | Internist - Addiction Medicine | K1059 | TX |
NPI | 1477581684 |
---|---|
Provider Name | Michael Sheth |
First Address | Pasadena, TX 77506-1400 |
Second Address | Pasadena, TX 77506-1400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 16/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1063513-03 | (05) | TX |
G36748 | (02) |