Healthcare Provider Details

I. General information

NPI: 1972740926
Provider Name (Legal Business Name): JAIME HALL-MALOUF, O.D. 20/20 VISION CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2009
Last Update Date: 12/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 W JAMES ST
WILLS POINT TX
75169-2049
US

IV. Provider business mailing address

140 W JAMES ST
WILLS POINT TX
75169-2049
US

V. Phone/Fax

Practice location:
  • Phone: 903-873-5757
  • Fax: 903-873-5522
Mailing address:
  • Phone: 903-873-5757
  • Fax: 903-873-5522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number06672
License Number StateTX

VIII. Authorized Official

Name: DR. JAIME GAILE HALL-MALOUF
Title or Position: OPTOMETRIST/OWNER
Credential: O.D.
Phone: 903-873-5757