Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 535546 | TX |
NPI | 1043397417 |
---|---|
Provider Name | Patricia L Hale |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78229-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 01/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
096180704 | (05) | TX |
096180705 | CSHCN (01) | TX |