Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | AP135770 | TX |
NPI | 1164935359 |
---|---|
Provider Name | Stephanie Gotcher |
First Address | Porter, TX 77365-4222 |
Second Address | Spring, TX 77373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2017 |
Last Update Date | 16/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AP135770 | (05) | TX |