Doctor Name: | JAMES DAVID MUNDT |
NPI Number: | 1013184597 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 5401 Fm 1626 Ste 135 Kyle, TX - 786406038 |
Business Phone Number: | 5122687850 |
Business Fax Number: | |
Mailing Address: | 5401 Fm 1626, Ste 135 KYLE |
State: | TX |
Postal Code: | 786406038 |
Phone Number: | 5122687850 |
Fax Number: | |
NPI Enumeration Date: | 05/13/2008 |
NPI Last Update Date: | 05/13/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |