Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 18405 | TX |
NPI | 1124195607 |
---|---|
Provider Name | Peter F Hazim |
First Address | Allen, TX 75013-3360 |
Second Address | Allen, TX 75013-3360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 13/07/2020 |