Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 9343 | TX |
N | 111NI0013X | Independent Medical Examiner | 9343 | TX |
NPI | 1164804050 |
---|---|
Provider Name | Phuc Armstrong |
First Address | San Antonio, TX 78249-1598 |
Second Address | Houston, TX 77042-3950 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2015 |
Last Update Date | 26/06/2015 |