Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213ES0103X | Foot & Ankle Surgery | 0871 | TX |
Y | 213ES0131X | Foot Surgery | 871 | TX |
NPI | 1093799249 |
---|---|
Provider Name | Paul Jeffrey Resignato |
First Address | El Paso, TX 79923-3192 |
Second Address | El Paso, TX 79936-8033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2005 |
Last Update Date | 04/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110391302 | (05) | TX |
T15506 | (02) | |
T15506 | (02) | TX |