Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 05918TG | TX |
NPI | 1003851452 |
---|---|
Provider Name | Hernan A Palermo |
First Address | Houston, TX 77081-5358 |
Second Address | Houston, TX 77081-5358 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2006 |
Last Update Date | 06/12/2017 |