Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1184938086 |
---|---|
Provider Name | Mr. Rhonney E Chacko |
First Address | Stafford, TX 77477-3902 |
Second Address | Stafford, TX 77477-3902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2010 |
Last Update Date | 09/03/2021 |