Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | J2612 | TX |
NPI | 1033101829 |
---|---|
Provider Name | Timothy Lebron Huggins |
First Address | Weatherford, TX 76086-5858 |
Second Address | Weatherford, TX 76086-5858 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
171261401 | (05) | TX |
E68296 | (02) | TX |