| NPI | 1053830695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALIK MAMDANI Authorized Official 972-850-8001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 6162-TG) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: TX 6162-TG) |
| 156FC0800X Technician/Technologist, Contact Lens | |
| 156FC0801X Technician/Technologist, Contact Lens Fitter | |
| 156FX1800X Technician/Technologist, Optician | |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2023-11-15 |