Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 0480 | TX |
N | 222Z00000X | Podiatrist | 0480 | TX |
N | 213ES0131X | Foot Surgery | 0480 | TX |
NPI | 1285628941 |
---|---|
Provider Name | Mr. J. Scott Littrell |
First Address | Waco, TX 76701-1019 |
Second Address | Waco, TX 76701-1019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00836901 | (05) | TX |
T14441 | (02) | TX |