Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 418481 | TX |
NPI | 1003970161 |
---|---|
Provider Name | Palestine M. Howie |
First Address | Dallas, TX 75266-0599 |
Second Address | Dallas, TX 75204-6109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2006 |
Last Update Date | 27/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
139698817 | (05) | TX |
139698819 | (05) | TX |
139698820 | (05) | TX |
139698821 | (05) | TX |
139698822 | (05) | TX |
139698823 | (05) | TX |
139698824 | (05) | TX |
139698825 | (05) | TX |
139698826 | (05) | TX |
139698827 | (05) | TX |
139698828 | (05) | TX |
8Y3534 | BLUE CROSS BLUE SHIELD (01) | TX |