| NPI | 1801421904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH MIRELES JACOBS Owner 256-265-7863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2020-08-14 |