Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0200X | Nurse Practitioner - Pediatrics | 26NJ00355300 | NJ |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 844835 | TX |
N | 363LP0200X | Nurse Practitioner - Pediatrics | TP006788D | PA |
NPI | 1003863911 |
---|---|
Provider Name | Mr. Raymond W. Kleposki III |
First Address | Dallas, TX 75219-3924 |
Second Address | Frisco, TX 75034-9580 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 07/03/2019 |