Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
1 | 207RP1001X | Internal Medicine | Pulmonary Disease | D0770 | TEXAS | No |
2 | 207R00000X | Internal Medicine | | D0770 | TEXAS | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
1 | 45JF | OTHER | TEXAS | BCBS GROUP |
2 | 864268 INDIV | OTHER | TEXAS | MEDICARE INDIV |
3 | 134105908 INDIV | OTHER | TEXAS | MEDICAID INDIV |
4 | 290015259 | OTHER | TEXAS | RAILROAD MEDICARE |
5 | 8G6240 | OTHER | TEXAS | BCBS INDIV |
6 | 00899T | OTHER | TEXAS | MEDICARE GROUP# (PTAN) |
7 | 45D 1005326 | OTHER | TEXAS | CLIA |
8 | A87096 | OTHER | TEXAS | UPIN INDIV |
9 | 154126001 GROUP TPI | MEDICAID | TEXAS | |