NPI | 1174719967 |
---|---|
Entity Type | Organization |
Authorized Contact | SHANE RAGSDALE Owner/President 940-387-9595 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: TX 7723-TG) |
Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: TX 7723-TG) |
152WP0200X Optometrist Pediatrics (Licence: TX 7723-TG) | |
152WS0006X Optometrist Sports Vision (Licence: TX 7723-TG) | |
Enumeration Date | 2007-09-14 |
Last Update Date | 2023-03-02 |