Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | A118857 | CA |
N | 207P00000X | Emergency Physician | MD454066 | PA |
N | 207P00000X | Emergency Physician | R3889 | TX |
N | 207RC0200X | Critical Care Medicine | MD454066 | PA |
Y | 207RC0200X | Critical Care Medicine | R3889 | TX |
NPI | 1003131616 |
---|---|
Provider Name | Mr. Daniel Rhodes Kievlan |
First Address | The Woodlands, TX 77380-3477 |
Second Address | The Woodlands, TX 77380-3477 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2010 |
Last Update Date | 12/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
377732801 | (05) | TX |