Dr. Humberto C. Fallas, O.D.
Optometrist in Mcdonough, GA. Individual provider (NPI-1).
NPI number1093926495
StatusActive
Last updated in NPPESApr 4, 2019
Details
- NPI
- 1093926495
- Entity type
- Individual (NPI-1)
- Name
- Dr. Humberto C. Fallas
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 25, 2007
- Last updated
- Apr 4, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | OPT001975 | GA | Yes |
| 152W00000X | Optometrist | OD00003708 | WA |
Practice location
69 Griffin StMcdonough, GA 30253-3138
Phone 770-954-9898 · Fax 770-954-9147
Mailing address
69 Griffin StMcdonough, GA 30253-3138
Phone 770-954-9898 · Fax 770-954-9147
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