Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | L5422 | TX |
NPI | 1033155379 |
---|---|
Provider Name | Robert C Kratschmer III |
First Address | Pearland, TX 77584-0118 |
Second Address | Pearland, TX 77581-8961 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 01/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I44142 | (02) |