Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 1309609 | TX |
Y | 213ES0000X | Sports Medicine | 1309609 | TX |
NPI | 1568095164 |
---|---|
Provider Name | Roxana Ventura |
First Address | Richmond, TX 77407-7851 |
Second Address | Houston, TX 77008-2853 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2020 |
Last Update Date | 21/02/2020 |