Healthcare Provider Details
I. General information
NPI: 1740946037
Provider Name (Legal Business Name): TN DOCTORS OF OPTOMETRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/11/2021
Last Update Date: 11/11/2021
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8113 MOORES LN STE 1800
BRENTWOOD TN
37027-8037
US
IV. Provider business mailing address
175 E HOUSTON STREET
SAN ANTONIO TX
78205-2255
US
V. Phone/Fax
- Phone: 615-309-5050
- Fax: 615-309-5054
- Phone: 800-340-0129
- Fax: 210-524-6587
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332H00000X |
| Taxonomy | Eyewear Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DOLSIE
MCDONALD
Title or Position: MANAGER
Credential:
Phone: 726-444-4078