Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | M3576 | TX |
NPI | 1003853276 |
---|---|
Provider Name | Nora Catherine Hart |
First Address | Shenandoah, TX 77385-3314 |
Second Address | Shenandoah, TX 77385 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 04/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
180573101 | (05) | TX |
180573103 | (05) | TX |
H01073 | (02) | TX |