Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | J7816 | TX |
NPI | 1255376984 |
---|---|
Provider Name | Regina L Lantin-Hermoso |
First Address | Houston, TX 77216-1088 |
Second Address | Houston, TX 77030-3000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 14/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
125708102 | CSHCN (01) | TX |
125708104 | (05) | TX |
370011877 | RAILROAD MEDICARE (01) | TX |
89Y084 | BCBS (01) | TX |
G34724 | (02) | TX |