NPI | 1780011734 |
---|---|
Entity Type | Organization |
Authorized Contact | KAMRAN MASSOUMI Owner 580-225-1555 |
Organization Subpart ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: OK 23117) |
Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2167) |
152W00000X Optometrist (Licence: OK 2718) | |
Enumeration Date | 2013-10-07 |
Last Update Date | 2024-05-09 |