Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | J6477 | TX |
N | 2080P0208X | Pediatric Infectious Diseases | J6477 | TX |
NPI | 1588623615 |
---|---|
Provider Name | Robert Douglas Hardy |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390-7208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2006 |
Last Update Date | 30/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
144260001 | (05) | TX |
H36578 | (02) |