Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 11529 | TX |
NPI | 1023359700 |
---|---|
Provider Name | Long Hong Ha |
First Address | Garland, TX 75044-7546 |
Second Address | Garland, TX 75044 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2013 |
Last Update Date | 06/03/2013 |