Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | E4831 | TX |
NPI | 1003841859 |
---|---|
Provider Name | William Donovan |
First Address | Houston, TX 77007-2264 |
Second Address | Houston, TX 77007-2264 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D48237 | (02) | TX |