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Individual
DR. TIFFANY REBECCA RISNER
Active
Individual
DR. TIFFANY REBECCA RISNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11001
TX
152W00000X
Optometrist
15046TLG
CA
152W00000X
Optometrist
OPT003303
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470989101
—
TX
Enumeration date
05/08/2014
Last updated
02/20/2024
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