Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | J6615 | TX |
NPI | 1013903624 |
---|---|
Provider Name | Robert Alan Naismith |
First Address | Corpus Christi, TX 78411-2547 |
Second Address | Corpus Christi, TX 78411-2548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2005 |
Last Update Date | 15/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G91410 | (02) | |
P0879021N4 | (05) | TX |