| NPI | 1427189968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVERETT A MOODY Owner President 972-258-7979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2022-02-25 |