Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 6325T | TX |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 6325T | TX |
NPI | 1104882745 |
---|---|
Provider Name | Dr. Higinio Cantres-Carmona |
First Address | El Paso, TX 79926-6513 |
Second Address | El Paso, TX 79936-5904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2006 |
Last Update Date | 23/04/2010 |