Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0203X | Pediatric Critical Care Doctor | K2437 | TX |
Y | 2080P0214X | Pediatric Pulmonologist | K2437 | TX |
NPI | 1396784518 |
---|---|
Provider Name | Steven Craig Copenhaver |
First Address | Dallas, TX 75230-2540 |
Second Address | Dallas, TX 75230-2540 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 29/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100757703 | (05) | TX |
G06370 | (02) | TX |