An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
TX license #H5664taxonomy 174400000X
Identifiers
Type
Value
Notes
01 (GA)
CS7990
RAILROAD MEDICARE
05 (TX)
094766501
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
None
Type code 4recorded 2008-01-25
Practice context
Multi-provider organization.
4 individual providers on file at this primary address.
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