Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | N9196 | TX |
N | 2080P0204X | Pediatric Emergency Doctor | N9196 | TX |
NPI | 1114199536 |
---|---|
Provider Name | Nicole Julia Corrigan-Garrett |
First Address | Dallas, TX 75230-5605 |
Second Address | Dallas, TX 75230-5605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2008 |
Last Update Date | 22/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
284686701 | (05) | TX |