Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 1 | TX |
N | 222Z00000X | Podiatrist | 1 | TX |
N | 224P00000X | Prosthetist | ||
Y | 224P00000X | Prosthetist | 1 | TX |
N | 225000000X | Orthotic Fitter | 1 | TX |
NPI | 1487822342 |
---|---|
Provider Name | Mr. Dale Stuart Lee Sheen |
First Address | Houston, TX 77290-0939 |
Second Address | Humble, TX 77338-3619 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2008 |
Last Update Date | 25/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1744P3200X | ORTHOTICS (01) | TX |