Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 01055347A | IN |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | N2584 | TX |
NPI | 1073715165 |
---|---|
Provider Name | Stacie Lynn Bingaman |
First Address | Fort Worth, TX 76104-4709 |
Second Address | Arlington, TX 76014-3174 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 01/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
204165904 | (05) | TX |
204165905 | (05) | TX |
204165906 | (05) | TX |