Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD38699 | TN |
Y | 2080P0210X | Pediatric Nephrologist | 42612 | TX |
NPI | 1194710087 |
---|---|
Provider Name | Shwu-Fang Lin |
First Address | Galveston, TX 77555-0373 |
Second Address | Galveston, TX 77555-0373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2005 |
Last Update Date | 10/01/2022 |