Individual
DR. DIEM CHI HERSCOVICI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
22002 US HIGHWAY 281 N, SUITE 102, SAN ANTONIO, TX 78258-7644
(830) 224-7911
Mailing address
301 S 320TH ST, FEDERAL WAY, WA 98003-5200
(253) 874-7000
(866) 559-3952
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
8987TG
TX
152W00000X
Optometrist
Primary
OD61371005
WA
152W00000X
Optometrist
TUV007843-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8987TG
TEXAS LICENSE
TX
01
—
TUV007843-1
LICENSE
NY
Enumeration date
06/22/2012
Last updated
05/23/2023
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