Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | FL |
NPI | 1104480920 |
---|---|
Provider Name | Harry Albert Hammett JR. |
First Address | Stafford, TX 77477-5565 |
Second Address | Stafford, TX 77477-5565 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2019 |
Last Update Date | 26/04/2019 |