Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1063599884 |
---|---|
Provider Name | John Shaver Zebrowski |
First Address | Odessa, TX 79761-1952 |
Second Address | Odessa, TX 79761-1952 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 09/07/2007 |