Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0600X | Clinical Neurophysiologist | D3778 | TX |
NPI | 1427332154 |
---|---|
Provider Name | Richard Ralph North |
First Address | Dallas, TX 75248-4791 |
Second Address | Dallas, TX 75248 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2011 |
Last Update Date | 29/09/2011 |