Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | E9990 | TX |
NPI | 1023069705 |
---|---|
Provider Name | Dr. Eugene Peter Sholdra |
First Address | Weatherford, TX 76086-5365 |
Second Address | Weatherford, TX 76086-5365 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 25/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
034228901 | (05) | TX |
B26422 | (02) | TX |