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 | 207Q00000X | Family Medicine | | | | No |
| 2 | 207R00000X | Internal Medicine | | | | No |
| 3 | 207RI0200X | Internal Medicine | Infectious Disease | | | No |
| 4 | 207QG0300X | Family Medicine | Geriatric Medicine | | | No |
| 5 | 2083P0011X | Preventive Medicine | Undersea and Hyperbaric Medicine | M0340 | TEXAS | No |
| 6 | 363A00000X | Physician Assistant | | | | No |
| 7 | 2083P0011X | Preventive Medicine | Undersea and Hyperbaric Medicine | | | Yes |
| 8 | 363L00000X | Nurse Practitioner | | | | No |