Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | II0154 | TX |
NPI | 1154321487 |
---|---|
Provider Name | Robert Talbot Baldwin |
First Address | Houston, TX 77253-3567 |
Second Address | Houston, TX 77074-1819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 24/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1039869-02 | (05) | TX |
89810B | BCBS (01) | TX |
F62849 | (02) |