Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 070704 | OK |
N | 176B00000X | Midwife | 659312 | TX |
NPI | 1023124104 |
---|---|
Provider Name | Mrs. Meghan Rae Stork |
First Address | Houston, TX 77266 |
Second Address | Houston, TX 77074 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 16/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
080462703 | (05) | TX |