NPI age
20 years
Enumerated 2005-12-14
Across 7867 active optometrist providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 3995TG | OD LICENSE NUMBER |
| 01 (TX) | 0178390001 | MEDICARE - PALMETTO DME |
| 05 (TX) | 019328601 | |
| 01 (TX) | 80236Q | BCBS |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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