Healthcare Provider Details
I. General information
NPI: 1144479387
Provider Name (Legal Business Name): OCULOPLASTIC ASSOCIATES OF TEXAS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/11/2008
Last Update Date: 05/29/2020
Certification Date: 05/29/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8230 WALNUT HILL LANE SUITE 508
DALLAS TX
75231-4400
US
IV. Provider business mailing address
8230 WALNUT HILL LANE SUITE 508
DALLAS TX
75231-4400
US
V. Phone/Fax
- Phone: 214-369-0555
- Fax: 214-363-6759
- Phone: 214-369-0555
- Fax: 214-363-6759
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | F1817 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
JAMES
H.
MERRITT
Title or Position: OWNER/SOLE MEMBER
Credential: M.D.
Phone: 214-369-0555