Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251E1200X | Ergonomics | 213201 | TX |
Y | 225XE1200X | Ergonomics | 213201 | TX |
NPI | 1174005581 |
---|---|
Provider Name | Josias Eugene |
First Address | Crowley, TX 76036-4361 |
Second Address | Crowley, TX 76036-4361 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2018 |
Last Update Date | 31/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3218065521 | 321806 (01) |