Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 24388 | TX |
NPI | 1245471481 |
---|---|
Provider Name | Dr. Lucy Kiome Nagashima |
First Address | Allen, TX 75002-3694 |
Second Address | North Richland Hills, TX 76180-7423 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2009 |
Last Update Date | 18/03/2009 |