Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 75754 | MI |
N | 207RG0300X | Geriatric Medicine | K9985 | TX |
NPI | 1023018686 |
---|---|
Provider Name | Sabina A Amin |
First Address | Fort Worth, TX 76120-2872 |
Second Address | Fort Worth, TX 76120-2872 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 05/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
167778301 | (05) | TX |
H19796 | (02) |