Healthcare Provider Details

I. General information

NPI: 1366436800
Provider Name (Legal Business Name): ASHLEY IRENE HUFF OD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: ASHLEY IRENE WEBER OD

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3034 BROADWAY BLVD
GARLAND TX
75041-3732
US

IV. Provider business mailing address

2113 ROCKBLUFF DR
ROWLETT TX
75088-6326
US

V. Phone/Fax

Practice location:
  • Phone: 972-278-2121
  • Fax: 972-926-1573
Mailing address:
  • Phone: 469-226-6981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number6770T
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: