| NPI | 1760507149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORETTA TAYLOR Credentialing Coordinator 817-529-9949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: TX L2508 L8376 L047) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2019-06-11 |