| NPI | 1891686135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER HASTIE VP, Credentialing & Payer Relations 214-415-9671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2025-07-14 |
| Last Update Date | 2025-07-14 |