Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | L4798 | TX |
NPI | 1053367722 |
---|---|
Provider Name | Richard Michael Warneke |
First Address | Webster, TX 77598-4055 |
Second Address | Webster, TX 77598-4052 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2006 |
Last Update Date | 16/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H83620 | (02) | TX |