Provider Demographics
NPI:1538940804
Name:PARTIDA, DULCE SONIA (EYEWEAR SUPPLIER)
Entity type:Individual
Prefix:
First Name:DULCE
Middle Name:SONIA
Last Name:PARTIDA
Suffix:
Gender:F
Credentials:EYEWEAR SUPPLIER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 LAKE CARNEGIE CT
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-2062
Mailing Address - Country:US
Mailing Address - Phone:956-635-7719
Mailing Address - Fax:
Practice Address - Street 1:10201 MCPHERSON RD STE 200
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-6880
Practice Address - Country:US
Practice Address - Phone:956-462-5006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32073038682332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier