Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME101776 | FL |
Y | 2080P0204X | Pediatric Emergency Doctor | N3099 | TX |
NPI | 1154476422 |
---|---|
Provider Name | Nakia Nicole Gaines |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390-7208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 21/08/2012 |