Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | R-2798 | AR |
N | 207VX0000X | Obstetrician | R-2798 | AR |
NPI | 1386725042 |
---|---|
Provider Name | Teresita Angtuaco |
First Address | Little Rock, AR 72205-7101 |
Second Address | Little Rock, AR 72205-7101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 26/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B89914 | (02) | |
P00020622 | RAILROAD MEDICARE (01) | AR |