Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | E0602 | TX |
NPI | 1013290949 |
---|---|
Provider Name | Myron R Zisman |
First Address | Denton, TX 76207-6629 |
Second Address | Denton, TX 76207-6629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2011 |
Last Update Date | 27/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E6002 | TEXAS MEDICAL LICENSE (01) | TX |