Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 13623 | TX |
NPI | 1639705403 |
---|---|
Provider Name | Robert David Pompella |
First Address | Temple, TX 76502 |
Second Address | Temple, TX 76502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2020 |
Last Update Date | 12/03/2020 |