Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1174055610 |
---|---|
Provider Name | Hoa Perkins |
First Address | Trophy Club, TX 76262 |
Second Address | Dallas, TX 75247 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2017 |
Last Update Date | 03/04/2017 |