Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1134468697 |
---|---|
Provider Name | Mr. Richard Norbert Florack |
First Address | Katy, TX 77450-7580 |
Second Address | Katy, TX 77450-7580 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2013 |
Last Update Date | 04/02/2013 |