Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 2543 | TX |
NPI | 1124329966 |
---|---|
Provider Name | Neville W. Buchanan |
First Address | San Antonio, TX 78212-5712 |
Second Address | San Antonio, TX 78212-5712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2010 |
Last Update Date | 10/11/2010 |