Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CA2400X | Assistive Technology Practitioner | ATP48380 | TX |
NPI | 1972887503 |
---|---|
Provider Name | Troy Liles |
First Address | Humble, TX 77338-5229 |
Second Address | Humble, TX 77338-5229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2011 |
Last Update Date | 07/03/2017 |