Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | S6264 | TX |
NPI | 1245763143 |
---|---|
Provider Name | Ramy Noche |
First Address | San Antonio, TX 78229 |
Second Address | San Antonio, TX 78251-3585 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2017 |
Last Update Date | 08/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
665028 | TMB (01) | TX |