Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0106X | Orthopaedic Hand Surgeon | 24233 | WV |
N | 207XS0106X | Orthopaedic Hand Surgeon | RS2020-0443 | NM |
Y | 207XS0106X | Orthopaedic Hand Surgeon | T4980 | TX |
N | 208200000X | Surgeon | 24233 | WV |
N | 208600000X | Surgeon | 24233 | WV |
N | 208200000X | Surgeon | T4980 | TX |
N | 208600000X | Surgeon | T4980 | TX |
NPI | 1063606721 |
---|---|
Provider Name | Nathan Gopi Menon |
First Address | San Angelo, TX 76901-5611 |
Second Address | San Angelo, TX 76901-5611 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2007 |
Last Update Date | 27/01/2022 |