Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | K8233 | TX |
Y | 208600000X | Surgeon | K8233 | TX |
NPI | 1023012069 |
---|---|
Provider Name | Nirmal Samuel Jayaseelan |
First Address | Dallas, TX 75230-2505 |
Second Address | Dallas, TX 75230-2505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 21/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
030421401 | (05) | TX |
G97553 | (02) |