Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 468 | TX |
Y | 222Z00000X | Podiatrist | 468 | TX |
NPI | 1003017781 |
---|---|
Provider Name | Miss Thomas Allen Shiller |
First Address | Corpus Christi, TX 78463-1580 |
Second Address | San Benito, TX 78586-5424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 08/07/2007 |