| NPI | 1710622345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN B BANK Mbr 214-773-9939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2022-04-28 |