Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 661710 | TX |
NPI | 1447490289 |
---|---|
Provider Name | Prof. Miles David Griffin |
First Address | Houston, TX 77030 |
Second Address | Houston, TX 77030-2703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2009 |
Last Update Date | 04/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1447490289 | BLUE CROSS BLUE SHIELD (01) | TX |
203053802 | (05) | TX |
203053803 | (05) | TX |
203053804 | (05) | TX |
8Y9619 | BCBSTX (01) | TX |