Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 0618002793 | VA |
N | 156F00000X | Technician/Technologist |
NPI | 1063728277 |
---|---|
Provider Name | Dr. Marie Lulette Pinto Fermil |
First Address | El Paso, TX 79911-3101 |
Second Address | El Paso, TX 79920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2010 |
Last Update Date | 09/01/2020 |