Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | H0153 | TX |
NPI | 1093892655 |
---|---|
Provider Name | Mrs. Bonnie J Baldwin |
First Address | Houston, TX 77074 |
Second Address | Houston, TX 77030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F29552 | (02) |