Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | 5207 | TX |
NPI | 1215078530 |
---|---|
Provider Name | Rodolfo J Orna |
First Address | Houston, TX 77079-5021 |
Second Address | Houston, TX 77079-1903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2007 |
Last Update Date | 22/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
182567101 | (05) | TX |
8800BH | BLUE CROSS BLUE SHIELD (01) | TX |