Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | S9674 | TX |
N | 208200000X | Surgeon | 46610 | TX |
N | 208600000X | Surgeon | 46610 | TX |
NPI | 1497103659 |
---|---|
Provider Name | Miss Lucia De Gregorio |
First Address | Dallas, TX 75390-7208 |
Second Address | Dallas, TX 75390-8466 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2016 |
Last Update Date | 04/06/2021 |