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General NPI Number Information
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NPI Number | 1215109780
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Entity Type | Individual
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Provider Name | HEPHZI THOMAS CST
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Gender | Female
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Dates
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Enumeration Date | 03/25/2008
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Last Update Date | 03/25/2008
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Provider Practice Location Address
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Address Line | 7801 ALMA DR
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City | PLANO
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State | TX
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Zip | 75025-3482
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Country | US
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Telephone | 214-714-7010
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Fax |
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Provider Business Mailing Address
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Address Line | 629 YOSEMITE TRL
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City | MESQUITE
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State | TX
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Zip | 75149-2584
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Country | US
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Telephone | 972-216-7711
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number | 90281
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License Number State | TX
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