Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 9925 | TX |
Y | 213EG0000X | General Practice | 9925 | TX |
NPI | 1003925777 |
---|---|
Provider Name | Richard Linden JR. |
First Address | Dallas, TX 75217 |
Second Address | Dallas, TX 75217 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 08/07/2007 |