Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1032208 | TX |
NPI | 1003491838 |
---|---|
Provider Name | Richard Zuidema |
First Address | Richmond, TX 77406-2577 |
Second Address | Houston, TX 77030-4549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2021 |
Last Update Date | 11/05/2021 |