Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | H5232 | TX |
NPI | 1013093202 |
---|---|
Provider Name | Mr. Byron Scott Dooley |
First Address | San Antonio, TX 78217 |
Second Address | San Antonio, TX 78258 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E48594 | (02) |