Healthcare Provider Details

I. General information

NPI: 1659547651
Provider Name (Legal Business Name): CORINTH EYECARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 08/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3960 FM 2181 STE:100
HICKORY CREEK TX
75065-4248
US

IV. Provider business mailing address

3960 FM 2181 STE:100
HICKORY CREEK TX
75065-4248
US

V. Phone/Fax

Practice location:
  • Phone: 940-497-4971
  • Fax: 940-497-4981
Mailing address:
  • Phone: 940-497-4971
  • Fax: 940-497-4981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberTX2519TG
License Number StateTX

VIII. Authorized Official

Name: DR. EMERY C. HUBER
Title or Position: OWNER/PRIMARY PROVIDER
Credential: O.D.
Phone: 817-633-2020