Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 1529 | TX |
NPI | 1013061670 |
---|---|
Provider Name | Yvette Elaine Forbes-Baker |
First Address | Arlington, TX 76017-5866 |
Second Address | Arlington, TX 76010-4426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 09/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1571598 | (05) | TX |
P00001015 | RAILROAD MEDICARE (01) | TX |
U72507 | (02) | NY |