Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | J8168 | TX |
NPI | 1063450948 |
---|---|
Provider Name | Richard Meredith Westmark |
First Address | Houston, TX 77058-3860 |
Second Address | Houston, TX 77058-3860 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
83151X | BCBS (01) | TX |
F45527 | (02) | TX |