Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | H3753 | TX |
NPI | 1306872353 |
---|---|
Provider Name | Tommy Chua Sim |
First Address | Friendswood, TX 77546-5147 |
Second Address | Friendswood, TX 77546-5147 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 18/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
123931101 | (05) | TX |
C33966 | (02) | TX |