Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | E9188 | TX |
NPI | 1215913751 |
---|---|
Provider Name | Roy D Elterman |
First Address | Dallas, TX 75230-2507 |
Second Address | Dallas, TX 75230-2507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2005 |
Last Update Date | 11/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B22529 | (02) |