Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1134760481 |
---|---|
Provider Name | Maria G Frias-Medina |
First Address | Sugar Land, TX 77479-1468 |
Second Address | Sugar Land, TX 77479-1468 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2019 |
Last Update Date | 07/10/2019 |