Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | 1261 | TX |
NPI | 1154916013 |
---|---|
Provider Name | Mr. James Brian Mcpherson |
First Address | Tyler, TX 75701-1834 |
Second Address | Tyler, TX 75701-1834 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2021 |
Last Update Date | 04/03/2021 |