Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 1781 | TX |
NPI | 1033282124 |
---|---|
Provider Name | Trisha Melaine King |
First Address | Lubbock, TX 79410-1320 |
Second Address | Lubbock, TX 79410-1320 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 25/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1923302 | (05) | TX |
192330208 | (05) | TX |
192330209 | (05) | TX |
192330210 | (05) | TX |
8K0921 | (02) | TX |
P01571957 | RAILROAD MEDICARE (01) | TX |