Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | J1998 | TX |
NPI | 1013093897 |
---|---|
Provider Name | Murray Bruce Fershtman |
First Address | The Woodlands, TX 77381 |
Second Address | Conroe, TX 77384 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F85036 | (02) |