MEDICARE: MRS. ASHLEY IRENE HUFF OD

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	6770T	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	81434Q	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1366436800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHLEY IRENE HUFF OD

Provider Business Mailing Address
First Line	:	2113 ROCKBLUFF DR
Second Line	:
City	:	ROWLETT
State	:	TX
Zip	:	75088-6326
Country	:	US
Telephone Number	:	469-226-6981
Fax Number	:

Provider Business Practice Location Address
First Line	:	3034 BROADWAY BLVD
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75041-3732
Country	:	US
Telephone Number	:	972-278-2121
Fax Number	:	972-926-1573

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	07/08/2007

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