Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 9345 | TX |
NPI | 1356350045 |
---|---|
Provider Name | Ms. Freda Marie Baham |
First Address | Bellaire, TX 77402-0525 |
Second Address | Houston, TX 77081-2706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 08/07/2007 |