Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | E7402 | TX |
NPI | 1497841431 |
---|---|
Provider Name | Ralph S. Freedman |
First Address | Houston, TX 77210-4439 |
Second Address | Houston, TX 77030-4009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 29/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036450701 | (05) | TX |
160016393 | RR MEDICARE (01) | TX |
800275 | BCBS (01) | TX |
C15745 | (02) |