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General NPI Number Information
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NPI Number | 1396307641
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Entity Type | Individual
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Provider Name | CIARRA HUMBLE OD
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Gender | Female
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Dates
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Enumeration Date | 07/07/2019
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Last Update Date | 07/07/2019
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Provider Practice Location Address
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Address Line | 1200 E ELDORADO PKWY STE 100
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City | LITTLE ELM
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State | TX
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Zip | 75068-5582
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Country | US
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Telephone | 972-292-0900
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Fax |
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Provider Business Mailing Address
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Address Line | 210 FENNELL DR
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City | MONROE
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State | LA
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Zip | 71203-3926
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Country | US
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Telephone |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9733T
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License Number State | TX
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