| NPI | 1588840292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN BOREN Office Manager 972-717-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: TX 2928TG) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 2928TG) |
| 152W00000X Optometrist (Licence: TX 6272TG) | |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: TX 6272TG) | |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2008-01-11 |