Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1700X | Ocularist | DR1396 | TX |
NPI | 1285801035 |
---|---|
Provider Name | Mr. Matthew Earl Layton |
First Address | Corpus Christi, TX 78411-1723 |
Second Address | Corpus Christi, TX 78411-1723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2008 |
Last Update Date | 12/05/2008 |