| NPI | 1487870309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD D DERRYBERRY Owner 972-931-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 4584TG) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: TX 4584TG) |
| 152WP0200X Optometrist, Pediatrics (Licence: TX 4584TG) | |
| 152WS0006X Optometrist, Sports Vision (Licence: TX 4584TG) | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2009-04-20 |