NPI age
19 years
Enumerated 2007-03-14
Across 7867 active optometrist providers in Texas.
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 210669201 | |
| 01 | 11763257 | CAQH |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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