MEDICARE: NOW SEE HERE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	01940TG	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326434549
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOW SEE HERE LLC

Provider Business Mailing Address
First Line	:	4560 W MOCKINGBIRD LN
Second Line	:	STE #124
City	:	DALLAS
State	:	TX
Zip	:	75209-5204
Country	:	US
Telephone Number	:	214-521-0929
Fax Number	:	214-751-3360

Provider Business Practice Location Address
First Line	:	4560 W MOCKINGBIRD LN
Second Line	:	STE #124
City	:	DALLAS
State	:	TX
Zip	:	75209-5204
Country	:	US
Telephone Number	:	214-521-0929
Fax Number	:	214-751-3360

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ORVILLE KEITH DISHMAN
Credential	:	O.D
Telephone Number	:	214-521-0929

Provider Enumeration Date	:	04/14/2015
Last Update Date	:	04/20/2015

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Directions to “NOW SEE HERE LLC ” Practice Location

Language	Start Address	Practice Location

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