Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | AP139807 | TX |
NPI | 1689148470 |
---|---|
Provider Name | Stephanie Kathrynann Angell |
First Address | Belton, TX 76513-2049 |
Second Address | Belton, TX 76513-2049 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2019 |
Last Update Date | 15/01/2019 |