Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | AP131648 | TX |
NPI | 1003347907 |
---|---|
Provider Name | Ramona Weiss |
First Address | Mckinney, TX 75069-1786 |
Second Address | Garland, TX 75042-6530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2017 |
Last Update Date | 22/03/2017 |