Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 22591 | TX |
NPI | 1144439589 |
---|---|
Provider Name | Walter Neal Horn |
First Address | Keller, TX 76262-9071 |
Second Address | Bedford, TX 76022-6667 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 14/04/2010 |