Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0117X | Orthopaedic Spine Surgeon | 45232 | TN |
NPI | 1134167695 |
---|---|
Provider Name | Robert Talac |
First Address | Richmond, TX 77406-5816 |
Second Address | Richmond, TX 77406-3609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 09/02/2017 |