Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 1056754 | TX |
NPI | 1982366209 |
---|---|
Provider Name | Jami Damron |
First Address | Pasadena, TX 77504-2117 |
Second Address | Pasadena, TX 77504-2117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2021 |
Last Update Date | 13/10/2021 |