Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | K8506 | TX |
Y | 208000000X | Pediatrician | K8506 | TX |
NPI | 1104906445 |
---|---|
Provider Name | Vernon Sutton |
First Address | Houston, TX 77030-2316 |
Second Address | Houston, TX 77030-2316 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 10/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
106130101 | (05) | TX |
106130103 | (05) | TX |
H18772 | (02) |