Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 1792 | TX |
NPI | 1003876616 |
---|---|
Provider Name | William A Sansing |
First Address | Amarillo, TX 79109-3009 |
Second Address | Amarillo, TX 79109-3009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 12/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T15737 | (02) | TX |