Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1337 | TX |
Y | 222Z00000X | Podiatrist | 1337 | TX |
NPI | 1023095783 |
---|---|
Provider Name | Scott Westmoreland |
First Address | San Angelo, TX 76902-7200 |
Second Address | San Angelo, TX 76903-5919 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U62281 | (02) | TX |