Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | 67 | TX |
NPI | 1003011024 |
---|---|
Provider Name | Mr. Dan Morgan |
First Address | Rio Frio, TX 78879-0183 |
Second Address | Houston, TX 77070-5641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 08/07/2007 |