Individual
KATUBIYA B BAKATUBIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3901 W 15TH ST, PLANO, TX 75075-7738
(972) 596-6800
Mailing address
10 WESTGROVE CT, MANSFIELD, TX 76063-5007
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
141611
TX
Other
Enumeration date
11/11/2011
Last updated
12/23/2011
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