Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | E1141 | TX |
NPI | 1033111885 |
---|---|
Provider Name | Mr. Steven J Steele |
First Address | Corpus Christi, TX 78411-1829 |
Second Address | Corpus Christi, TX 78411-1829 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 10/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
114041003 | (05) | TX |
C22205 | (02) |