Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 5131T | TX |
NPI | 1245433176 |
---|---|
Provider Name | Trang Huynh |
First Address | Tomball, TX 77375-6518 |
Second Address | Tomball, TX 77375-6518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
760489644 | TAX ID (01) | TX |