Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | F5176 | TX |
N | 208600000X | Surgeon | F5176 | TX |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | F5176 | TX |
NPI | 1063511186 |
---|---|
Provider Name | Vincent R Conti |
First Address | Galveston, TX 77555-5302 |
Second Address | Galveston, TX 77555-5302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 21/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
132657103 | (05) | TX |
132657107 | (05) | TX |
B21962 | (02) | TX |