Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | F9876 | TX |
NPI | 1245231281 |
---|---|
Provider Name | Mr. Donald Cade Nelms |
First Address | Katy, TX 77450 |
Second Address | Katy, TX 77450-2243 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F61306 | (02) | TX |