Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | J5527 | TX |
NPI | 1043396484 |
---|---|
Provider Name | William J Riley |
First Address | Galveston, TX 77555-5302 |
Second Address | Akron, OH 44308-1063 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 05/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0895107 | (05) | OH |
D86213 | (02) | |
T0176756 | TPI (01) | TX |