Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 0389 | TX |
Y | 222Z00000X | Podiatrist | 0389 | TX |
NPI | 1053479592 |
---|---|
Provider Name | Mr. M Stuart Altman |
First Address | Denton, TX 76205 |
Second Address | Denton, TX 76205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T11930 | (02) |