Individual
ERIC DEMOND GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
90 PINE ST, SHEPHERD, TX 77371
(713) 882-0779
Mailing address
90 PINE ST, SHEPHERD, TX 77371-6597
(713) 882-0779
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
11271506
TX
Other
Enumeration date
09/07/2017
Last updated
07/21/2022
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