Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | 10085 | TX |
Y | 213ER0200X | Radiology | 10085 | TX |
NPI | 1952514788 |
---|---|
Provider Name | Trevor Hi Foshang |
First Address | Dallas, TX 75229-5609 |
Second Address | Dallas, TX 75229-5609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 08/07/2007 |