Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 12978 | TX |
NPI | 1003924556 |
---|---|
Provider Name | Phyllis H Tuthill |
First Address | Houston, TX 77070-6317 |
Second Address | Houston, TX 77070-6317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 08/07/2007 |