Healthcare Provider Details
I. General information
NPI: 1699446377
Provider Name (Legal Business Name): SAGINAW FAMILY EYECARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/23/2021
Last Update Date: 04/27/2022
Certification Date: 04/27/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
616 E BAILEY BOSWELL RD STE 200
SAGINAW TX
76131-3575
US
IV. Provider business mailing address
616 E BAILEY BOSWELL RD STE 200
SAGINAW TX
76131-3576
US
V. Phone/Fax
- Phone: 682-382-2020
- Fax:
- Phone: 682-382-2020
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANJONETTE
COLVIN
Title or Position: OWNER
Credential: OD
Phone: 817-701-8775