NPI age
20 years
Enumerated 2005-10-19
Across 7867 active optometrist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 1216087-04 | |
| 01 | 1411926 | TPIN - GOV. CONTRACTS |
| 01 (TX) | 3607TG | OPTOMETRIC LICENSE |
| 01 (TX) | R0100468 | DPS NUMBER |
| 01 | 790417448 | DUNS # |
| 01 | 752106346 | FED TAX ID |
| 01 | 0663220001 00E07B | DME # |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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