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General NPI Number Information
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NPI Number | 1093251340
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Entity Type | Organization
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Legal Business Name | MELISSA EYE ASSOCIATES
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3591 MCKINNEY STREET STE. 200
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City | MELISSA
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State | TX
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Zip | 75454-9571
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Country | US
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Telephone | 972-837-2222
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Fax | 972-837-2223
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Provider Business Mailing Address
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Address Line | 3591 MCKINNEY STREET STE. 200
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City | MELISSA
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State | TX
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Zip | 75454-9571
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Country | US
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Telephone | 972-837-2222
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Fax | 972-837-2223
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Authorized Official
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Title or Position | OWNER
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Name | MR. COLY BRETT MARSH
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Credential | O.D.
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Telephone | 972-837-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5423TG
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License Number State | TX
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