Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175M00000X | Lay Midwife | 96152 | TX |
Y | 176B00000X | Midwife | 96152 | TX |
NPI | 1164598942 |
---|---|
Provider Name | Mrs. Brenda Theresa Buffington |
First Address | Livingston, TX 77351 |
Second Address | Livingston, TX 77351 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2006 |
Last Update Date | 16/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3648065 | (05) | TX |