Healthcare Provider Details

I. General information

NPI: 1275799918
Provider Name (Legal Business Name): SHARP OPTICAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 08/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 N PLANO RD # 100
RICHARDSON TX
75081-2427
US

IV. Provider business mailing address

1410 NORTH PLANO #100
PLANO TX
75081
US

V. Phone/Fax

Practice location:
  • Phone: 972-530-8800
  • Fax:
Mailing address:
  • Phone: 972-530-8800
  • Fax: 972-761-0388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number2606TG
License Number StateTX

VIII. Authorized Official

Name: DR. DAVID ROBERT FRAZEE
Title or Position: PRESIDENT
Credential: O.D.
Phone: 972-530-8800