Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 13615 | TX |
NPI | 1003908088 |
---|---|
Provider Name | Dr. Lionel Joseph Fourrier JR. |
First Address | Hockley, TX 77447-8788 |
Second Address | Waller, TX 77484 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 08/07/2007 |